脾动脉栓塞与脾切除的对比分析

目的探讨脾动脉栓塞和脾切除治疗脾功能亢进的疗效及并发症,为临床治疗脾功能亢进方式提供选择依据。方法回顾分析我院近年部分性脾动脉栓塞46例和脾切除33例,比较两种方法治疗后血象改善及并发症发生情况。结果两种方法均能有效改善肝硬化继发脾肿大脾功能亢进患者血小板和白细胞计数(P<0.001),但两组患者中脾切除组术后血小板计数改善明显优于脾动脉栓塞组,而白细胞计数的改善两组无明显差异。脾动脉栓塞组术后并发症发生率明显高于脾切除组(P<0.001)。结论对于腹水较多、门脉高压明显、脾脏巨大的患者不宜行脾动脉栓塞治疗,行脾切除术较好;对于肝脏功能较差、凝血功能严重障碍、高龄和伴肝癌的脾功能亢进患者宜行脾动脉栓塞治疗。

Contrast analysis of the partial splenic artery embolization with splenectomy

Objective To analyze the effects and the complications of partial splenic artery embolization(PSE)and splenectomy offering a feasible way to choose different therapeutic methods for hypersplenism. Methods Forty-six patients treated with PSE and thirty-three undergone splenectomy were compared for their effectivenesses and complications in treating hypersplenism. Results Thrombocyte and leucocyte counts increased markedly after the two kinds of treatment(P < 0.001). However the PLT-improvement of the splenectomy group was superior to that of the PSE group. The change of the WBC showed no statistical difference(P > 0.05). The complication rate of the PSE was far more than that of the splenectomy(P < 0.001). Conclusions Splenectomy is prior to PSE on patients with large mount of ascites, serious portal hypertension and splenomegaly. PSE is suitable for patients with poor liver function, lood coagulation disturbance, liver cancer complicatid with hypersplenism and aging.