大、小明胶海绵颗粒行部分脾栓塞术临床疗效对比  

Partial splenic embolization by using larger or smaller gelatin sponge particles:a comparison of clinical efficacy

作　　者：周瑶军[1,2] 刘长江[1] 王要军[1] 

机构地区：[1]济南解放军济南军区总医院消化科,250031 [2]河南濮阳市油田总医院重症医学科

出　　处：《介入放射学杂志》2013年第4期322-325,共4页Journal of Interventional Radiology

摘　　要：目的评价大、小明胶海绵颗粒栓塞剂行部分脾栓塞术(partial splenic embolization,PSE)对肝硬化脾功能亢进患者的疗效。方法 2010年3月至2011年5月收治52例肝硬化脾功能亢进患者,行PSE治疗。依据术中采用明胶海绵颗粒大小不同分为大颗粒(2 mm×2 mm×2 mm)组17例和小颗粒(560～710μm)组35例。选取术后3个月栓塞范围在30%～40%的40例进行分析,其中大颗粒组16例,小颗粒组24例,观察两组外周血白细胞、血小板和红细胞计数变化及术后反应。结果与术前相比,两组术后3个月WBC、PLT、RBC均升高,差异有统计学意义(P<0.05);但两组间差异无统计学意义(P>0.05)。大颗粒组Ⅱ、Ⅲ度疼痛分别为13%(2/16)和38%(6/16),小颗粒组分别为42%(10/24)和4%(1/24),组间差异有统计学意义(P=0.05)。疼痛持续时间在大颗粒组为5～20 d,平均(11.4±4.8)d,小颗粒组为0～8 d,平均(3.8±2.2)d,小颗粒组术后疼痛较大颗粒组轻(P<0.05),发热、呕吐情况两组间差异无统计学意义(P>0.05)。结论大、小颗粒组术后3个月外周血象改善情况无显著性差异,但小颗粒组术后疼痛较轻。objective TO evaluate the clinical efficacy of partial splenic embolization （PSE） by using larger or smaller gelatin sponge particle as embolic material in treating hypersplenism due to cirrhosis. Methods During the period from March 2010 to May 2011, a total of 52 patients with hypersplenism due to cirrhosis were treated with PSE at authors＇ hospital. Larger size （2 mm ×2 mm×2 mm） or smaller size （560 -710 μm） of the gelatin sponge particle was used as embolic material. Based on the particle size used in PSE, the patients were divided into the larger particle group （n = 17 ） and the smaller particle group （n = 35）. Splenic embolization extent of 30% - 40% at 3 months after PSE was seen in 40 patients, including 16 patients of larger particle group and 24 patients of smaller particle group. During follow-up time, the white blood cell （WBC）, platelet （PLT） and red blood cell （RBC） were estimated, and the postoperative complications associated with PSE were recorded. The results were analyzed. Results In both groups, the postoperative 3- month WBC, PLT and RBC counts were significantly higher than preoperative ones （P 〈 0.05）, although the differences in WBC, PLT and RBC counts were not significant between the two groups （P 〉 0.05）. In the larger particle group the Ⅱ and Ⅲ degree of abdominal pain were seen in 13% （2/16） and 38% （6/16） of patients respectively, while in the smaller particle group the Ⅱ and Ⅲ degree of abdominal pain were seen in 42% （10/24） and 4% （1/24） of patients respectively; the difference between the two groups was of statistically significant （P = 0.05）. The lasting time of abdominal pain in the larger particle group was 5 - 20 days with a mean of （11.4± 4.8） days, while in the smaller particle group the lasting time of abdominal pain was 0 - 8 days with a mean of （3.8 ± 2.2） days. The postoperative pain degreein the smaller particle group was slighter than that in the larger particle group （P 〈 0.05�

关 键 词：脾功能亢进 部分脾动脉栓塞术 明胶海绵颗粒 

分 类 号：R575.2[医药卫生—消化系统]