部分性脾栓塞在肝癌伴脾功能亢进中的临床应用  

Clinical application of partial splenic embolization in primary hepatocellular carcinoma complicated with hypersplenism

作　　者：蒋锐[1] 何乾文[1] 顾明[1] 柯振武[1] 李建浩[1] 

机构地区：[1]成都军区总医院放射科,四川成都610083

出　　处：《四川医学》2010年第8期1180-1182,共3页Sichuan Medical Journal

摘　　要：目的探讨部分性脾栓塞在肝癌伴脾功能亢进中的疗效及临床意义。方法对34例肝癌合并肝硬化门脉高压患者采取肝动脉化疗和部分性脾脏栓塞术,其中12例2次行PSE,3例3次行PSE,术后定期复查血常规和肝功能。结果共行部分性脾脏栓塞52例次。栓塞范围30%-60%,栓塞后有49例次出现发热,大部分持续3-30d,46例次出现腹痛,其中4例次需要强效止痛药,少量胸腔积液6例次,保守治疗后消失,未出现脾脓肿等严重并发症。术后WBC和PLT显著升高（P〈0.05）,并长期维持在较高水平,RBC和Hb量无明显改变（P〉0.05）,TBA下降（P〈0.05）,TBIL、ALT和AST无明显变化（P〉0.05）。结论部分性脾脏栓塞治疗肝癌伴脾功能亢进是一种有效、安全、微创的方法,它可以有效改善血象和肝功能,提高机体免疫力,为进一步化疗打下基础。Objective To explore the therapeutic and significance of partial splenic embolization（PSE） in interventional treatment of primary hepatocellular carcinoma complicated with hypersplenism.Methods 34 patients underwent transcatheter arterial chemoembolization（TACE） and partly splenic artery for hepatic carcinoma with hepatocellular carcinoma patic cirrhosis and venous hypertension.After the treatment,the blood profile and liver function were regularly tested.Results 52 times of embolization were performed in 34 patients involving 49 times of fever lasting 3-30 days and 46 times of bellyache with 4 times appealing for pethidine.Treatable hydrothorax appeared in 6,and no serious complications occurred.The area of embolization cover 30%-60%.WBC and PLT increased significantly after the treatment（P〈0.05） and lasted for a long time at a relatively high level.No marked changes in RBC count,Hb,TBIL,ALT and AST were found（P〈0.05）.TBA decreased（P〈0.05）.Conclusion PSE is an effective,safe and mini-invasive procedure to treat hepatocellular carcinoma concomitant with hersplenism,besides,to increase blood cell counts and elevate immunity.PSE is helpful for hepatic arterial chemoembolization.

关 键 词：肝癌 脾功能亢进 部分性脾脏栓塞 化疗 

分 类 号：R735.7[医药卫生—肿瘤] R551.1[医药卫生—临床医学]