部分脾栓塞治疗肝硬化脾功能亢进的安全性分析  

Analysis of the safety of partial splenic embolization in the treatment of liver cirrhosis and hypersplenism

作　　者：邬芳玉[1] 

机构地区：[1]江西省南昌市第九医院肝五科,南昌330002

出　　处：《江西医药》2015年第7期626-628,共3页Jiangxi Medical Journal

摘　　要：目的通过对肝硬化并脾功能亢进(以下简称脾亢)患者行部分脾栓塞术(partial splenic embolization,PSE)后并发症的回顾性分析,探讨PSE的安全性。方法 92例肝硬化并脾亢患者根据Child-pugh分级分为A、B、C 3组,分别为32例、41例、19例,均接受PSE治疗(控制脾栓塞面积在50%-70%),记录并发症的发生情况。结果患者均有发热及脾区疼痛,其余并发症以腹水及腹膜炎最常见,分别为32例及23例。C组腹水及腹膜炎的发生率最高,与A组及B组相比均有差异(P<0.05),但A组与B组相比无显著差异。结论肝硬化并脾亢患者术前充分保肝降低Child-pugh评分、术中控制栓塞面积及部位、术后预防感染,可以减少PSE的并发症,继而提高PSE的安全性。Objective To investigate the safety of partial splenic artery embolization （referred to PSE） through retrospectively analysing the complications after PSE of the patients with hypersplenism in cirrhosis. Methods 92 consecutive patients with hy-persplenism in cirrhosis received PSE（the splenic embolization area was 50-70%）. According to Child-pugh classification,the pa-tients were divided into three groups（group A、B、C）who all received PSE（the embolization area was about 50%-70%）：n（A）=32,n （B）=41,n（C）=19. We Record the complications of all patients.Results：Patients experienced fever （92,100%）,pain in the region of the spleen （92,100%）,the most common complications ascites and peritonitis respectively happened to 32 and 23 patients.There was no death case. The incidence of ascites and peritonitis in group C is significantly higher than those in group A or group B（P〈0. 05）. But the incidence of ascites and peritoitis was not different between group A and group B. Conclusion Adequately protecting preoperative liver,controlling the intraoperative embolization area and position,and strengthening postoperative anti-inflammatory, can reduce the complications and then improve the safety of PSE in the patients with hypersplenism in cirrhosis.

关 键 词：部分脾栓塞 肝硬化 脾功能亢进 

分 类 号：R575.2[医药卫生—消化系统]