部分脾动脉栓塞术治疗肝炎后肝硬化并发脾功能亢进  

Partial splenic embolization for treating post hepatitis cirrhosis with hypersplenism Analysis of 40 cases

作　　者：张兴仕[1] 庄明[1] 吴金平[1] 霍志芬 

机构地区：[1]常州市第三人民医院放射科

出　　处：《介入放射学杂志》1999年第1期15-17,共3页Journal of Interventional Radiology

摘　　要：目的探讨部分脾动脉栓塞术（ＰＳＥ）治疗肝炎后肝硬化并发脾功能亢进的疗效及评价。材料和方法４０例经实验室检查诊断为病毒性肝炎，外周全血细胞减少，ＣＴ或Ｂ超确诊为肝硬化、脾肿大。采用改良Ｓｅｌｄｉｎｇｅｒ技术，将导管插至脾动脉注入明胶海绵颗粒或细条，术后观察外周血细胞改变。结果４０例中显效３１例，占７７．５％，有效４例，占１０％，无效５例。占１２．５％，总有效率８７．５％。结论部分脾动脉栓塞术治疗肝炎后肝硬化并发脾功能亢进，是一种损伤小、安全程度高，副反应少，疗效好的办法，可部分替代外科切脾手术，值得普及推广。Objective To evaluate the effect of partial splenic embolization (PSE) for post hepatitis cirrhosis with hypersplenism.Materials and Methods Altogether 40 cases with decrease of all types peripheral blood cell count and swelling of spleeas (male 24, female 16, age 30～61 years) coused by post hepatitis and cirrhosis dignosed through laboratory test, CT and/or B Ultrasound. Using on Seldinger's method, the catheter was inserted into splenic artery and then granules or tiny stripls of gelfoam was injected through the catheter. Afterward, peripheral blood cell's count was taken into acount.Results There were 31 cases of obvious effect (77.5%), lese in 4 effect (10%) and no effect in 5 (12.5%). Total effective rate was 87.5%. Conclusions PSE in treating hypersplenism is method of mild injury, high security, less side effect and good efficiency. The splenic PSE could take the place of surgical splenectomy and should be propularised under certain condition. The patients of Child A or partially Child B should be selected as the candidate.

关 键 词：脾动脉栓塞 肝炎 肝硬化 脾功能亢进 介入疗法 

分 类 号：R657.630.5[医药卫生—外科学] R575.206[医药卫生—临床医学]