射频消融治疗门静脉高压性脾功能亢进的临床研究

目的探讨射频消融(RFA)脾脏治疗门静脉高压性脾功能亢进症(脾亢)的可行性、有效性和临床应用前景。方法对28例肝硬变、门静脉高压性脾亢患者实施脾脏RFA治疗,对随访1年的9例患者进行实验室数据和影像资料分析。结果9例接受RFA治疗的患者随访时间超过1年。住院治疗期间无操作相关死亡率,主要并发症是胸腔积液(3／9)和轻微腹痛(4／9)。每次操作平均毁损30．7％(20％-43％)脾脏体积,血小板计数于术后14d达到峰值。随访期间白细胞和血小板计数、肝功能以及肝动脉血流量得到显著改善,并发生硬化肝脏增生的现象。结论RFA是治疗门静脉高压性脾亢安全、有效的微创手段。肝动脉血流量增加能明显改善肝脏功能,并可能诱导肝脏再生。

Radiofrequency ablation for hypersplenism due to portal hypertension: clinical study

Objective To investigate the feasibility, efficacy and clinical prospects of radiofrequency ablation (RFA) for hypersplenism in patients with liver cirrhosis and portal hypertension. Methods The laboratory and radiologic data over one-year period of patients undergone splenic RFA were analyzed.Results Nine patients undergone splenic RFA has closely followed-up over 1 year. During hospitalization, no procedure-related complications occurred, only minor complications including hydrothorax (3/9 patients) and mild abdominal pain (4/9 patients) were observed. After treatment, average 30.7% (20%-43%) of spleen volume was ablated, and the platelet count reached peak on 14th post-procedure day. White blood cell and platelet counts, liver function, and hepatic artery blood flow had gained significant improvements comparing with those before RFA procedures. Hyperplasia/regeneration was also occurred in cirrhotic liver after splenic RFA.Conclusion Radiofrequency ablation is a safe, effective and minimally invasive approach for the management of hypersplenism in patients with liver cirrhosis and portal hypertension. Increased hepatic artery blood flow can contribute to significant improvement of liver function, and maybe potentially stimulate liver regeneration in cirrhotic liver.