超选择性部分脾栓塞治疗原发性肝癌伴脾亢的临床应用

目的 探讨超选择性部分脾动脉栓塞治疗原发性肝癌伴发脾功能亢进的临床应用价值.方法 22例原发性肝癌伴脾功能亢进的患者,肝功能Child Pugh分级A／／B级,采用TACE＋PSE,每次脾脏栓塞范围约10%~30%,栓塞次数2～4次,至脾脏总的栓塞范围约60%~70%,记录术后外周血象变化情况及术后并发症.结果 整个疗程后,所有患者的外周血象均达到正常水平,术后未出现严重并发症.结论 超选择性部分脾动脉栓塞治疗原发性肝癌伴发的脾功能亢进,能准确控制脾动脉栓塞的范围及位置,安全而有效.

The Clinical application of the ultra-selective partial splenic embolization in the treatment of primary liver cancer with hypersplenism

Objective To investigate the ultra-selective partial splenic embolization（PSE） in the treatment of primary liv- er cancer associated with spleen hyperfunction clinical value. Methods 22 patients with liver cancer and hypersplenism, Child-Pugh score was A and B. These patients were treated with transcatheter arterial chemoembolization（TACE）in combination with PSE. In all patients, 10% ~ 30% of splenic parenchyma was infracted every PSE and 60% ~ 70% of splenic parenchyma was infracted accumulatively by PSE for 2 ~ 4 times, follow-up the changes in peripheral hemogram and observation complication in all patients. Results All patients completed the course of treatments. Peripheral hemogram was back to normal in all patients. No se- vere complication was occurred. Conclusion The scope and location of the ultra-selective partial splenic embolization in the treatment of primary liver cancer associated with l~ypersplenism, accurate control of the splenic artery embolization is safe and ef- fective.