脾内注射无水乙醇治疗脾功能亢进症的研究  

Studies of treatment of hypersplenism with injection of absolute alcohol into spleens

作　　者：刘凤芹[1] 楚更五[2] 佟继铭[2] 张学军[1] 秦殿菊[1] 刘玉玲[2] 陈光辉[2] 

机构地区：[1]承德医学院附属医院消化科,河北省承德市067000 [2]承德医学院,河北省承德市067000

出　　处：《世界华人消化杂志》2000年第12期1381-1384,共4页World Chinese Journal of Digestology

基　　金：河北省卫生厅资助;No.99091~~

摘　　要：目的探索脾内注射无水乙醇治疗脾亢的可行性.方法①正常 Wistar 大鼠、豚鼠、犬三种动物麻醉、剖腹,在直视下于脾内注射无水乙醇0.2mL～0.4mL,并用生理盐水同量注射作对照.术后1wk～6wk 处死,取脾、肝、肾作病理检查.②肝硬变、脾亢患者3例,于脾切除前用5号针刺入脾内4～5点,观察拔针后变化.结果三种动物脾内注射无水乙醇或生理盐水后,以及脾亢患者拔针后,均有大量血液溢出脾表面.脾内有大片出血区,注射无水乙醇处,自 wk2开始出现坏死灶,细胞崩解、溶解.以后随时间延长病灶内有淋巴细胞、纤维细胞、结缔组织增生并逐渐包裹坏死区.肝、肾病检未见异常.结论脾内注射无水乙醇确实能使脾脏产生部分纤维化,达到缩小脾脏、治疗脾亢的目的.但也存在内外出血的危险性.应进一步研究解决出血的方法,在无有效止血方法之前,不适宜广泛应用于临床.AIM To investigate the usability of injection of 100% alcohol into spleens in treating hypersplenism. METHODS Adult Wistar rats,Guinea-pigs and dogs were randomly divided into experimental groups and Ns control groud.Under general anaesthesia,abdomen were opened to expose the spleen.The experimental animal was injected with 100% alcohol(0.2 to 0.4mL),and Ns control animals were injected with normal saline(NS)into spleens.All animals were killed respectively after injection and spleens,livers and kidneys were taken for pathological studies.In cirrhotic patients with hypersplenism,spleens were punctured with # 5 needle before splenectomy. RESULTS In both animals and patients,there was significant hemorrhage at the injected spots after the needle was taken out of spleen.In experimental animals a large area of hemorrhage were found in spleen in the first week after injection.On the spot,focal necrosis occurred,in which the splenocyte necroeed and then lymphocyte and fibroblasts migrated into necrosis foci.In the sixth week hyperplastic connective tissues bundled the necrosis foci.No pathological changes were seen in kidneys and livers. CONCLUSION Injection of 100% alcohol into spleens can make the spleen fiberized and reduced,so that it can be used to treat hypersplenism.But there was a danger of internal and external bleeding.The extensive clinical practice is not appropriate until an effective method that can stop the hemorrhage resulting from the injection has been found.

关 键 词：脾功能亢进 治疗 病灶内注射 动物实验 

分 类 号：R55[医药卫生—血液循环系统疾病]