部分性脾栓塞在肝癌介入治疗中的应用（附30例报告）  

Applicationofpartialsplenicembolizationin30casesofhepatocelularcarcinomaassociatedwithportalhypertensionandhypersplenismHanMingjun

作　　者：韩铭钧[1] 赵仲春[1] 任克[1] 张汉国[1] 徐克[1] 张曦彤[1] 

机构地区：[1]中国医科大学第一临床学院放射科

出　　处：《中华放射学杂志》1996年第9期616-619,共4页Chinese Journal of Radiology

摘　　要：目的：探讨部分性脾栓塞（ＰＳＥ）在肝癌介入治疗中的意义和方法。材料与方法：采用肝动脉化疗栓塞术（ＴＨＡＥ）和ＰＳＥ并用的方法治疗３０例合并肝硬化、门脉高压和脾功能亢进的肝癌患者。将ＰＳＥ的栓塞材料明胶海绵限制在１６０粒以内以防止过量栓塞。结果：２７例脾栓塞面积在５０％以上；２５例脾功能亢进缓解；２６例食管静脉曲张包括６例有消化道出血者，５例于ＰＳＥ后１年之内未再发生出血；未发生脾脓肿等严重并发症。３例脾栓塞面积在５０％以下的患者中２例脾功能亢进未缓解。结论：ＰＳＥ与ＴＨＡＥ并用是治疗肝癌合并肝硬化、门脉高压和脾功能亢进的安全、有效的方法。栓塞剂定量的方法有助于避免脾的过量栓塞，减少并发症。Purpose:Tostudytheefectandmethodofpartialsplenicembolization(PSE)intheinterventionaltreatmentofhepatocelularcarcinoma.Materialsandmethods:Transcatheterhepaticarterialembolization(THAE)combinedwithPSEwasperformedin30patientswithhepatocelularcarcinomacomplicatedwithlivercirhosis,portalhypertensionandhypersplenism.GelfoamspongewasusedastheembolicmaterialforPSEandlimitedto160piecestopreventoverembolization.Re-sults:Morethan50%ofsplenicparenchymawasinfarctedin27patients.Leukopeniaandthrombo-cytopeniawerecorrectedbyPSEin25of27patientswithhypersplenism.In26patientswithesophagealvaricesincluding5patientswhohadepisodesofgastrointestinalbleeding,norebleedingocurredinfolow-upperiodof6～7months.Hypersplenismwasnotcorectedin2of3patientswithinfarctedsplenicparenchymalessthan50%.Nosplenicabscesandotherseverecomplicationswereobserved.Conclusion:THAEcombinedwithPSEisasafeandefectiveprocedureforpatientswithhepatocelularcarinomaasociatedwithlivercirrhosis,portalhypertensionandhypersplenism.

关 键 词：肝肿瘤 脾栓塞术 介入疗法 

分 类 号：R735.705[医药卫生—肿瘤]