脾动脉栓塞术治疗肝癌合并脾功能亢进的疗效分析

目的:探讨肝炎肝硬化后肝癌患者伴有脾功能亢进行部分脾动脉栓塞术(partial splenic embdization,PSE)治疗的临床疗效。方法:收集2013年3月至2017年3月间就诊于我院并经临床、生化检验和病理证实为肝细胞癌、脾功能亢进的患者24例，影像学及临床资料完整，总结脾动脉栓塞术的有效性及影响疗效的因素。结果:24例患者中男性16例，女性8例，年龄38~77岁，平均年龄(55.5±9.87)岁，均进行肝动脉化疗栓塞术（TACE）联合脾动脉栓塞术（PSE）治疗，其中栓塞比率＜50%的9例，50%~70%的8例，＞70%的7例，栓塞体积最大约1 261.30 ml，最小约118.40 ml，平均约(427.02±256.93) ml，术后患者白细胞（WBC）及血小板(PLT)较前可见明显提高，PLT升高值、PLT升高比及WBC升高比同脾脏栓塞比率及栓塞体积呈明显相关，中性粒细胞(NE)升高比同栓塞体积呈明显相关，淋巴细胞(LYM)升高比及血红蛋白(Hb)升高比同栓塞比率明显相关。结论:PSE治疗肝癌合并脾功能亢进安全、有效，栓塞的百分比及栓塞的体积为PSE治疗效果的主要影响因素。

Clinical efficiency of partial splenic embolization in treating hypersplenism combined with hepatocellular carcinoma

Objective:To evaluate the efficacy of partial splenic embolization（PSE）for hypersplenism combined with hepatocellular carcinoma.Methods:Retrospectively analyze clinical findings of 24 patients with hypersplenism combined with hepatocellular carcinoma by pathology and laboratory examination from March 2013 to March 2017.Results:In this trail we included 24 patients,16 males and 8 females,(55.5±9.87) years old range from 38 to 77 years old.All the patients underwent TACE and PSE treatment.The infracted ratio of 9 cases were less than 50%,8 cases range 50% to 70%,7 cases more than 70%.The infarcted splenic volume was from 118.40 ml to 1 261.30 ml,average infarcted splenic volume (427.02±256.93) ml.WBC and PLT counts significantly were increased than pre-embolization values.The PLT increase value and PLT increase ratio were and WBC increase ratio correlated with the infarcted splenic volume and infarcted splenic ratio,neutrophile cell increase ratio correlated with the infarcted splenic volume,lymphocyte and Hb increase ratio correlated with the infarcted splenic ratio.Conclusion:Partial splenic embolization（PSE） is a safety and efficiency treatment for hypersplenism combined with hepatocellular carcinoma.The efficiency of PSE is correlated with the infarcted splenic volume and infarcted splenic ratio.