部分性脾动脉栓塞术治疗肝硬化并脾功能亢进的临床应用  

Clinical Application of Partial Splenic Embolization in Treating Hepatocirrhosis Combined with Hypersplenism

作　　者：苑静波[1] 贾丽英[1] 啜振华[2] 刘冲[1] 

机构地区：[1]河北医科大学中医院放射科,河北省石家庄市050011 [2]石家庄铁路中心医院影像科

出　　处：《中国全科医学》2005年第8期627-628,共2页Chinese General Practice

摘　　要：目的探讨部分性脾动脉栓塞术治疗肝硬化并脾功能亢进的临床应用价值。方法肝硬化合并脾功能亢进患者38例,以Seldinger技术经股动脉穿刺插管至脾动脉主干并注入明胶海绵颗粒,造成脾动脉远端部分细小血管的栓塞及相应脾组织坏死,栓塞范围为40%～70%。结果栓塞后患者外周血白细胞、红细胞和血小板均有不同程度的升高,和治疗前相比差别有显著性意义(P<0.01),未出现脾脓肿、急性胰腺炎等严重并发症。结论该方法具有创伤小、疗效确切以及可保留脾脏生理功能等优点。合理控制栓塞范围、严格无菌操作及抗生素的合理应用是减少术后并发症的关键。Objective To study the clinical application value of the Partial Splenic Embolization (PSE) in the treatment of hypersplenism resulting from hepatocirrhosis.Methods Thirty-eight cases with hypersplenism resulting from hepatocirrhosis were included in this study.With the Seldinger technique,the catheter was inserted to the main splenic artery and granulations of gelfoam were injected,as a result,embolization and necrosis of distal small arteries as well as partial spleen tissue occurred.The scope of embolization was controlled between 40%～70%.Results After the treatment,the level of leucocytes,erythrocytes and throbocytes in peripheral circulation had been raised to varying degrees and a significant difference could be observed when compared with the level before treatment (P<0.01).No severe complications such as splenic abscesses and acute pancreatitis occurred.Conclusion In treating hypersplenism resulting from hepatocirrhosis this method has advantages such as very small trauma,reliable effectiveness and reservation of the physiological function of the spleen.The key to reduce post-operative complications may be reasonable control of the embolization scope,strict aseptic manipulation as well as reasonable application of antibiotics.

关 键 词：动脉栓塞术治疗 脾功能亢进 部分性 SELDINGER技术 经股动脉穿刺插管 临床应用价值 明胶海绵颗粒 外周血白细胞 脾脏生理功能 肝硬化合并 严重并发症 急性胰腺炎 术后并发症 动脉主干 组织坏死 细小血管 不同程度 合理控制 

分 类 号：R683.305[医药卫生—骨科学] R657.63[医药卫生—外科学]