超声引导冷循环微波消融治疗继发性脾功能亢进的初步研究  

The Preliminary Study of Secondary Hypersplenism with Ultrasound-guided Cold Cycle Microwave Ablation

作　　者：彭红艳[1] 余松远[1] 贺飞[1] 吴华丽[1] 秦梦斌 陈丽[1] 马苗[1] 

机构地区：[1]武汉科技大学附属天佑医院超声医学科,武汉市430064

出　　处：《中国超声医学杂志》2017年第6期530-532,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的初步探讨超声引导下冷循环微波消融治疗肝硬化脾肿大、脾功能亢进的临床疗效。方法选择38例肝硬化伴有脾增大、脾功能亢进患者,超声引导下对脾组织行经皮微波消融,术后即刻行超声造影观察消融范围,分别于治疗前及术后1周、1、3、6、12、24个月检测患者外周血常规观察白细胞、血小板变化;术后观察患者并发症发生情况。结果消融治疗后外周血白细胞、血小板1周开始升高,到1个月白细胞、血小板明显升高,与治疗前相比差异有统计学意义(P<0.05)。升高持续3、6、12个月分别为17、12、5例,24个月仍较术前明显升高4例。超声造影观察微波消融范围越大,白细胞、血小板计数越高。术后出现并发症12例,无严重并发症发生。结论超声引导经皮冷循环微波消融作为一种微创方法治疗继发性脾增大、脾功能亢进,短期内疗效确切,并发症少,患者术后恢复快,具有重要的临床应用价值。Objective To preliminary explore the clinical curative effect of splenomegaly and hypersplenism secondary to liver cirrhosis with cold cycle microwave ablation guided by ultrasound. Methods The 38 cirrhosis patients with secondary splenomegaly and hypersplenlsm were treated with ultrasound-guided splenic percutaneous microwave ablation, ablation range was observed by contrast-enhanced ultrasound（CEUS） immediately, the changes of white blood cells（WBCs） and platelets were observed before and 1 week, 1,3,6,12,24 months after the treatment respec tively,and complications of patients also were observed. Results The peripheral blood WBCs and platelets began to rise 1 week after ablation, and increased significantly after 1 months, the difference was statistically significant （P〈0.05）. 17 cases,12 eases,5 cases keep rising for3 months, 6 months,12 months respectively, and4 cases were significantly increased after 24 months. The larger the ranges of microwave ablation were observed by CEUS, the higher WBCs and platelets counts. 12 cases have complications, but no serious complications after treatment. Conclusions Ultrasound-guided percutaneous cold cycle microwave ablation can treat secondary splenomegaly and hypersplenism, the curative effect is definite with less complications, and patients recover quickly, which has important clinical value as a minimally invasive method in the short-term.

关 键 词：超声引导 微波消融 脾功能亢进 

分 类 号：R445.1[医药卫生—影像医学与核医学] R551.1[医药卫生—诊断学] R575.2[医药卫生—临床医学]