放射治疗与介入治疗肝源性脾亢75例  

Radiotherapy versus interventional therapy for hepatogenic hypersplenism:An analysis of 75 cases

作　　者：王丽娜[1] 何津祥[1] 靳炘[1] 刘兆辰[1] 李丰旭[1] 

机构地区：[1]兰州大学第一医院放疗科,甘肃省兰州市730000

出　　处：《世界华人消化杂志》2012年第24期2296-2301,共6页World Chinese Journal of Digestology

基　　金：甘肃省科技攻关基金资助项目;No.2GS054_A43_014_04~~

摘　　要：目的:比较放射性外照射、三维适形放疗及介入治疗肝源性脾亢的疗效、不良反应及住院费用.方法:选择60名肝硬化脾亢患者和15名原发性肝癌合并脾亢患者作为研究对象,前者分为肝硬化脾脏介入治疗组和肝硬化脾脏外照射治疗组;肝硬化脾亢采用脾脏外照射治疗,介入治疗采用部分脾脏栓塞术,肝癌合并脾亢采用脾脏三维适形放疗,评价3组治疗前、治疗中及治疗后脾脏大小、血常规指标、不良反应及住院费用情况.结果:治疗后3组患者脾脏均显著缩小,白细胞计数、血红蛋白和血小板计数均显著升高(P<0.05),但3组患者脾脏大小及血常规指标变化之间均无显著性差异(P>0.05).治疗后肝硬化脾脏外照射及肝癌脾脏三维适形放疗组发热和疼痛评价指标较介入治疗组显著减轻(0.57±0.55,0.64±0.51vs1.80±1.21;0.36±0.63,1.67±1.12vs4.59±3.22,均P<0.05).肝硬化脾脏外照射放疗组住院费用显著低于肝癌脾脏三维适形放疗组和介入组.结论:放射性外照射治疗肝硬化脾亢、三维适型放射治疗肝癌合并脾亢可达到和介入治疗相同的疗效,并能显著减轻发热和疼痛反应,缩减治疗费用.AIM： To compare the clinical effects, adverse re- actions and hospitalization expenses of external irradiation therapy, three dimensional conformal radiation therapy and interventional therapy for the treatment of hepatogenic hypersplenism. METHODS： Sixty patients with hypersplenism secondary to liver cirrhosis and 15 patients with hypersplenism secondary to liver cancer were selected. Patients with hypersplenism secondary to liver cirrhosis were divided into two groups： one was treated with external irradiation and the other with interventional therapy. Patients with hypersplenism secondary to liver cancer were treated with three dimensional conformal radia-tion therapy. Spleen size, blood routine index, adverse reactions and hospitalization expenses were compared among the three groups. RESULTS： Spleen size was reduced and white blood cell count, hemoglobin and platelet count increased significantly in all the three groups of patients after treatment （all P 〈 0.05）. But no sig- nificant differences were observed in spleen size and routine blood parameters between the three groups after treatment （P 〉 0.05）. Fever index and pain index were significantly reduced in the external irradiation and three dimensional con- formal radiation therapy groups compared to the interventional therapy group （0.57 ± 0.55, 0.64 ± 0.51 vs 1.80 ± 1.21; 0.36 ± 0.63, 1.67 ± 1.12 vs 4.59 ± 3.22, all P 〈 0.05）. The hospitalization expenses were reduced in the external irradiation group compared to the other two groups. CONCLUSION： External irradiation and three dimensional conformal radiation therapy can achieve the same effects as the interventional therapy and are associated with reduced side effects and hospitalization expenses in the treat- ment of hepatogenic hypersplenism.

关 键 词：脾功能亢进 肝硬化 肝癌 放射治疗 介入治疗 

分 类 号：R575.2[医药卫生—消化系统]