末梢动脉分散栓塞法行部分性脾栓塞治疗脾功能亢进

目的探讨末梢动脉分散栓塞法在部分性脾动脉栓塞术(PSE)中的应用价值。方法 30例肝硬化合并脾功能亢进患者,应用PVA-500颗粒经导管于脾门处脾动脉主干缓慢注入,使PVA-500颗粒分散分布于脾脏边缘,栓塞面积控制在40%左右,栓塞术后观察患者并发症、血象回升及维持情况。结果 24例出现不同程度的发热,其中低热4例,中等度发热14例,高热6例;左侧腹部疼痛19例;吸气性左胸痛4例;6例出现腹水,6例出现反复呃逆;肝功能与术前比较一过性损害17例;术后1周白细胞由术前(2.58±0.36)×109/L升至(11.09±1.31)×109/L,血小板由术前(47.08±6.60)×109/L升至(91.41±16.99)×109/L,红细胞由术前(3.01±0.75)×1012/L升至(3.53±0.68)×1012/L。术后3个月血象维持正常者21例,血象下降至术前水平者推荐再次栓塞治疗。结论末梢动脉分散栓塞法治疗脾功能亢进具有反应轻、疗效满意的优点,可以在脾功能亢进患者部分性脾脏栓塞术中应用。

Efficacy of peripheral artery scattered embolization used to PSE in the treatment of hypersplenism

Objective To investigate the value of peripheral artery embolism method used in to partial splenic artery embolization(PSE).Methods The 30 cases of hepatic cirrhosis with hypersplenism patients received following therapy: PVA-500 granule through spleen and splenic artery transcatheter was slowly injected;the PVA dispersion distribution in edge of the spleen,embolization in the area around 40%,embolism observation on postoperative complications,hematologic recovery and maintenance were taken.Results Of 24 cases with varying degrees of fever(low,4 cases;14 cases of moderate fever;hyperthermia,6 case);19 cases were of abdominal pain on the left side,4 of inspiratory chest pain left,6 cases of ascites,6 cases of repeated hiccups;Compared with preoperative liver function transient damage was in 17 cases;later 1 week after operation white blood cells from the preoperative(2.58±0.36) rose ×109/L(11.09±1.31)×109/L,the preoperative platelet from(47.08±6.60)×109/L rose(91.41 ±16.99) ×109/L,red blood cells from preoperative(3.01 ±0.75) ×1012/L rose(3.53 ±0.68) ×1012/L.Three monthes after operation 21 patient's blood picture became normal.When blood picture fell to the preoperative level embolization was recommended again.Conclusion Peripheral artery embolization used in the treatment of splenic function is of light reaction,satisfaction,thus using this method to perform partial splenic embolization could be used in hypersplenism patients.