超选择脾下极动脉栓塞治疗脾功能亢进临床研究

目的:探讨超选择脾下极动脉栓塞治疗脾功能亢进的方法及临床价值。方法:2004—2005年对30例脾功能亢进患者给予超选择脾下极动脉栓塞治疗,栓塞剂为1mm×1mm×1mm的明胶海绵颗粒。结果:对30例脾功能亢进患者均行了部分性脾栓塞,在术后几个小时即可出现血小板和白细胞计数的增加,多在2周内逐渐恢复正常。各例患者脾脏栓塞后均有明显缩小,5～6周后稳定。3例腹水消退。结论:行超选择脾下极动脉栓塞该叶段脾实质,防治脾动脉分支短期再通,同时可准确控制脾脏栓塞面积。导管头端尽量深入脾动脉,避开共干动脉,可避免发生胃肠道的栓塞、急性胰腺炎等严重并发症。

Clinical study on ultra-selective embolization in lower pole of spleen for hypersplenia

Objective To explore the method and value of super-selective embolization in lower pole of spleen for hypersplenia. Methods From 2004 to 2005, 30 patients with hypersplenia were treated with gelfoam particles by super-selective intraarterial embolization in lower pole of spleen. Results All patients were treated with partial splenic embolization. The blood platelet and white blood cell count increased within several hours after operations, and gradually recovered normal in 2 weeks.Heavy ascits in 3 cases disappeared. Conclusion Super-selective catheterization and embolization of lower pole arteries of spleen may accurately control the spleen embolism area and can avoid the serious illness complication, such as the unexpected gastro-intestinal tract embolism and the acute pancreatitis.