部分脾脏栓塞术治疗肝硬化门脉高压合并脾机能亢进的临床研究  

Clinical study of partial splenic embolization for patients with hypersplenism and cirrhotic portal hypertension

作　　者：王文明[1] 王保华[1] 盛玉国[1] 李乃选[1] 荆秀荣[1] 段新武[1] 许春华[1] 

机构地区：[1]山东滨州医学院附属医院介入医学科,山东滨州256603

出　　处：《医学影像学杂志》2004年第6期458-460,共3页Journal of Medical Imaging

摘　　要：目的 :探讨部分脾脏栓塞术对肝硬化门脉高压合并脾机能亢进的治疗价值。方法 :应用PVA颗粒 ,对 4 6例门脉高压肝硬化合并脾脏机能亢进的患者施行经脾动脉部分脾脏栓塞术 ,随访术后不同时间窗内疗效并对比研究了栓塞前后的门静脉和脾静脉血流速度的变化。结果 :4 6例患者成功施行了经脾动脉栓塞技术 ,达到了临床预期的治疗目标 ,消除了脾机能亢进的症状 ,无严重并发症发生 ,白细胞和血小板术后 2 4h即有明显改善 (P <0 .0 5 ) ,4周后恢复正常水平保持平稳。脾静脉和门静脉血流速度手术后明显降低 (P <0 .0 5 ) ,随访 6～ 2 1个月 ,脾机能亢进的症状未复发。结论 :部分脾脏栓塞术简便微创安全 ,治疗肝硬化门静脉高压合并脾机能亢进疗效好 ,值得临床推广应用。Objective:To study the clinical efficacy of partial splenic embolization(SPE) for patients with hypersplenism and cirrhotic portal hypertension.Methods:46 patients were performed SPE procedures for hypersplenism owing to cirrhotic portal hypertension in 46 patients. Different periods of follow-up results were evaluated in all patients, blood flow velocity of portal and splenic veins were compared respectively between pre and post-embolization procedure.Results:Procedure was succeeded technically and hypersplenism was improved in all patients. No severe complication was occurred. And platelet and leukocyte counts improved significantly after 24hs of procedure in most patients and normal or keeping high serum level throughout the follow-up period after 4 weeks in all patients. Blood flow velocity of portal and splenic veins were decreased significantly(P<0.05). In the period of 6～21months follow-up, no patient was recurred hypersplenism Conclusion:PSE procedure is minimal invasive, safe and effective for patients with hypersplenism syndrome.

关 键 词：脾脏机能亢进 放射学 介入性 栓塞 

分 类 号：R575.2[医药卫生—消化系统] R815[医药卫生—内科学]