小颗粒、超选择部分脾动脉栓塞治疗脾功能亢进的应用  

Superselective Partial Splenic Embolization with Small PVA Particles for Hepatic Cirrhosis with Hypersplenia

作　　者：姜兵[1] 王朝阳[1] 

机构地区：[1]湖南省第二人民医院放射科,长沙410007

出　　处：《中国现代手术学杂志》2016年第1期69-72,共4页Chinese Journal of Modern Operative Surgery

基　　金：湖南省第二人民医院重点科室扶持项目

摘　　要：目的探讨小颗粒、超选择行部分脾栓塞术（partial splenic embolization,PSE）治疗肝硬化脾功能亢进患者的疗效。方法回顾性分析2005年3月～2014年12月收治的63例肝硬化脾功能亢进患者的临床资料,采用PVA（200～500μm）小颗粒、超选择至脾段动脉及以下动脉行PSE治疗。观察术前、术后白细胞、红细胞及血小板计数变化及手术并发症。结果本组63例患者于栓塞后2～3 d,白细胞和血小板即开始回升,其中以白细胞回升最快,一般1周左右恢复到正常范围。术后第1个月、第3个月复查及1年随访,外周血白细胞、血小板、红细胞均在正常范围内。其中有1例患者在1周后出现门静脉血栓,余无其他不良并发症发生。结论小颗粒、超选择部分脾动脉栓塞治疗脾功能亢进创伤小,恢复快,效果满意,并发症少,值得临床推广应用。Objective To explore the effect of superselective partial splenic embolization（ PSE） with small PVA particles for treatment of liver cirrhosis patients with hypersplenism. Methods The clinical data of 63 liver cirrhosis cases with hypersplenism were analyzed retrospectively from 2005 March to 2014 December.The surgery of superselective PSE with small PVA particles（ 200 to 500 μm） was performed to splenic artery and branch artery. The blood WBC,RBC and platelet count was observed and the post-operative complications were studied before and after operation. Results The WBC and platelet count began to rebound 2 to 3 days after PSE. And the WBC was the fastest in increase and restored to normal in 1 week. All index of WBC,RBC and platelet count were restored to normal range in re-exam of 1-,3 months and 1 year follow-up. There was portal vein thrombosis in one case 1 week after PSE. Conclusion Superselective PSE with small PVA particle is an effective therapy for hypersplenism with advantages as mini-trauma,quick recovery and less complication,and it is worthy of clinical application.

关 键 词：脾功能亢进 脾动脉栓塞术 部分 

分 类 号：R551.1[医药卫生—血液循环系统疾病] R575.2[医药卫生—内科学]