合并脾功能亢进原发性肝癌双介入治疗利弊和指征

目的 :探讨肝、脾动脉双栓塞治疗伴脾功能亢进原发性肝癌的利弊和指征。方法 :经股动脉穿刺分别行肝、脾动脉的化学灌注栓塞和明胶海绵栓塞为观察组 ,并对比观察单纯行肝动脉化学灌注栓塞术组 (对照组 )对血细胞、肝功能、免疫状况、生活质量及平均住院日等方面的影响。结果 :观察组 6 8例治疗后血细胞均见不同程度增高 ,白细胞分布范围 (5 .0～ 2 0 .0 )× 10 9/ L,血小板多在原水平呈现倍增 ;对照组 6 0例治疗后均出现白细胞和血小板减少 ,两组肝功能、免疫指标、KPS评分等未见明显异常 ,平均住院日分别为 16 .2天和 31.4天。结论 :肝脾动脉双栓塞对合并脾功能亢进原发性肝癌有较好疗效 ,特别是外周血白细胞、血小板明显减少者 ,为综合治疗赢得了时间 ,但对老年患者和肝功能 Child分级差者慎用

PARTIAL SPLENIC EMBOLIZATION FOR HYPERSPLENISM CONCOMITANT WITH ARTERIAL EMBOLIZATION OF PHCC

Objective:To study the value of partial splenic embolization(PSE) for the treatment of hypersplenism in patients undergoing embolization of primary hepatocellular carcinoma (PHCC).Methods:Transcatheter hepatic arterial chemoembolization(TACE) combined with PSE was performed in 68 patients with PHCC complicating liver cirrhosis and hypersplnism.Gelfoam sponge was used as the emboulic material for PSE.And also 60 patients without PSE were followed as control.Results:All patients after TACE and PSE showed a good response on peripheral blood cell count,especially leukocyte and thrombocyte;these paremeters tenden to decrease in control patients without PSE.Conclusions:PSE combined with TACE is a safe and effective measure for patients with PHCC,except for older patients and the liver function Child C cases.