脾动脉血管硬化剂栓塞治疗脾功能亢进  

Partial splenic embolization by using hardeners in hypersplenism

作　　者：李京雨[1] 张强[1] 梁俊生[2] 刘明[1] 徐力扬[1] 陆海容[2] 

机构地区：[1]解放军北京军区总医院放射诊断科,100700 [2]解放军第二六六医院放射科

出　　处：《中华放射学杂志》2005年第3期302-305,共4页Chinese Journal of Radiology

摘　　要：目的评价应用血管硬化剂行部分性脾栓塞治疗脾功能亢进的疗效及安全性。方法17例肝硬化脾功能亢进患者,使用微导管行脾脏中下极动脉分支超选择插管硬化剂栓塞。硬化剂包括鱼肝油酸钠和无水乙醇。栓塞体积40%~70%。结果术后2~4周白细胞平均值自(25±12)×109/L[(08~42)×109/L]增至(57±17)×109/L[(37~84)×109/L],t=6257,P<0001;血小板平均值自(34±14)×109/L[(14~61)×109/L]增至(108±48)×109/L[(58~210)×109/L],t=7028,P<0001。无严重的术后不良反应或并发症。结论脾中下极动脉硬化剂栓塞治疗脾功能亢进安全、有效,不良反应轻,同时具有操作简便和相对经济的优点。Objective To assess the efficacy and safety of partial splenic embolization (PSE) by using hardeners in hypersplenism. Methods By means of super-selective catheterization of the splenic artery branches, 17 patients with hepatic cirrhosis underwent PSE by injection of Absolute ethanol or sodium morrhuate through micro-catheter into the middle and lower pole of the spleen. Total hardener volume used in one patient was 6-16 ml according to the blood flow volume of the target vessel. Lidocaine and antibiotics were injected before hardener to release pain and prevent infection. Embolization area was controlled as about 40%-70% of the spleen. Results Within 2 to 4 weeks after PSE, the average WBC count increased from (2.5±1.2)×109/L [(0.8-4.2)×109/L] to (5.7±1.7)×109/L [(3.7-8.4)×109/L] (t=6.257, P<0.001); and average platelet count from (34±14)×109/L [(14-61)×109/L] to (108±48)×109/L [(58-210)×109/L] (t=7.028, P<0.001). Massive low density area in embolized middle and lower pole of the spleen was showed on CT scan. Neither severe side-effects nor complications occurred. A-2-year long-term follow-up in 5 cases indicated no recurrence. Conclusion^Middle and lower pole embolization of the spleen using hardeners has the advantages of less side-effects, easy manipulation and economical expense. It is effective and safe for the treatment of hypersplenism.

关 键 词：脾功能亢进 血管硬化 栓塞治疗 脾动脉 并发症 不良反应 硬化剂 安全 体积 操作 

分 类 号：R551.1[医药卫生—血液循环系统疾病]