部分性脾栓塞术在肝癌伴脾功能亢进治疗中的应用

目的评价部分性脾栓塞术（PSE）在原发性肝癌伴脾功能亢进介入治疗中的疗效及临床意义。方法原发性肝癌伴脾功能亢进患者12例，男10例，女2例．平均年龄51．1岁；肝功能Child－PughA级3例，B级9例；在行肝动脉插管化疗栓塞术（TACE）的同时行PSE；术后定期复查血常规和肝功能。结果本组脾栓塞面积为50％～60％，无脾脓肿等严重并发症。术后WBC和PLT显著提高（P〈0．05），并长期维持在较高水平，RBC数量和HG量无明显改变（P〉0．05）。TBIL、ALT和AST无明显变化（P〉0．05），TBA下降（P〈0．05）。结论PSE能纠正脾功能亢进，提高血WBC和PLT的数量，使原发性肝癌伴脾功能亢进患者的TACE能顺利进行，是一种安全、有效的治疗方法。

Application of partial splenic embolization in treatment of primary hepatocellular carcinoma complicated with hypersplenism

Objective To evaluate the therapeutic effect and clinical significance of partial splenic embolization （PSE） in interventional treatment of primary hepatocellular carcinoma complicated with hypersplenism. Methods Twelve cases of primary hepatocellular carcinoma complicated with hypersplenism, including 10 males and 2 females, with an average age of 51.1 year old underwent transcatheter arterial chemoembolization （TACE） in combination with PSE. The liver function grade was Child A （3 patients） or Child B （9 patients）. After the treatment, the blood profile and liver function were regularly tested. Results In all patients, 50%-60% volume of splenic parenchyma was infracted with PSE. No splenic ab scesses or other severe complications occurred. WBC and platelet count （PLT） increased significantly after the treatment （P〈0.05） and lasted for a long time at a relatively high level. No marked changes in RBC counts were found （P〉0.05）. The levels of TBIL, ALT and AST did not change significantly （P〉0.05）while that of TBA markedly decreased （P〈 0.05）. Conclusion PSE is a safe and effective method which can correct hypersplenism, improve the value of WBC and PLT, and smoothen the TCAE.