PSE联合手术治疗门脉高压症合并脾功能亢进的临床研究  

A clinical study of PSE combined with surgery for treatment of hypertension and hypersplenism

作　　者：钱小星[1] 吴茂松[1] 陈克辉[1] 周高潮[1] 刘咸罗[1] 徐晓峰[1] 王家文[1] 汤永胜[1] 

机构地区：[1]合肥市第二人民医院血管外科,230011

出　　处：《安徽医学》2012年第2期152-154,共3页Anhui Medical Journal

基　　金：安徽省卫生厅医学科研课题(项目编号:09A073)

摘　　要：目的分析部分脾动脉栓塞术(PSE)作为门脉高压症合并脾功能亢进患者术前提升血小板的可行性,探讨PSE术后进行脾切除联合门奇断流术的最佳手术时机。方法本组15例患者行PSE术后,观察PSE对血小板上升时间的影响,并明确血小板上升到适宜手术的时间。PSE术后2周内行脾切除联合门奇断流术,术中观察脾脏与周围组织的粘连情况,并明确PSE后进行手术的最佳时机。结果 PSE术后血小板开始升高,1周时达峰值;脾脏与大网膜及周围组织发生粘连,粘连程度与PSE术后手术时间呈正相关。结论 PSE纠正脾功能亢进,改善凝血功能障碍作用明显,可作为门脉高压而脾亢明显的患者行脾切除、门奇断流术的一种术前准备措施。PSE术后2周内是进行脾切除的最佳时机。Objective To analysis the possibility of partial splenic embolization（PSE） as a method of portal hypertension in patients with hypersplenism before surgery to enhance platelet.Methods To observe the changes in the number of platelet after PSE in the group of 15 patients and determine the operation time according to the changes in the number of platelet.Splenectomy combined wth portal azygous disconnection was conducted in 2 weeks after PSE,the spleen and the surrounding tissue adhesions were observed intraoperation,and the best time of surgery was determined.Results Platelets began to increase after PSE and peaked at 1 week;Adhesions of spleen and the omentum and the surrounding tissue with the time of postoperation of PSE was time-dependent.Conclusion PSE can correct hypersplenism and can be as preparation measures in patients wth significant portal hypertension and hypersplenism.The best time of splenectomy is in 2 weeks after PSE.

关 键 词：脾动脉部分栓塞术 脾切除 门脉高压症 脾功能亢进 

分 类 号：R575.2[医药卫生—消化系统]