部分脾动脉栓塞治疗肝硬化脾功能亢进的作用机制  

The mechanism of action of partial splenic artery embolization in treatment of liver cirrhosis and hypersplenism

作　　者：李宗伟 汪桠琴 张跃伟 LI Zongwei;WANG Yaqin;ZHANG Yuewei(Department of Hepatobiliary and Pancreatic Surgery,The Affiliated Hospital of Qinghai University,Xining 810001,China;Department of Hepatobiliary Intervention,Beijing Tsinghua Changgung Hospital,Beijing 102218,China)

机构地区：[1]青海大学附属医院肝胆胰外科,西宁810001 [2]北京清华长庚医院肝胆介入科,北京102218

出　　处：《临床肝胆病杂志》2023年第7期1714-1720,共7页Journal of Clinical Hepatology

基　　金：首都卫生发展科研专项(2020-2-2242);清华大学精准医学科研计划(10001020103)。

摘　　要：脾功能亢进(脾亢)是由肝硬化、门静脉高压引起的常见并发症,目前临床治疗脾亢的主要方式是脾切除和部分脾动脉栓塞(PSE)。脾切除治疗脾亢效果确切,可显著改善脾亢患者临床症状。相比于脾切除,部分脾动脉栓塞通过栓塞脾动脉分支使部分脾实质梗死,能够达到与部分脾切除术相似的临床疗效,并保留脾脏及脾脏自身功能。虽然PSE是治疗脾亢的有效方法,但是目前国内外关于PSE对肝纤维化、免疫及肝再生影响的研究报道并不多。本文总结了脾亢发生的常见病因、PSE治疗脾亢机制、不同栓塞方法和材料的治疗效果,以及PSE对肝纤维化、免疫及肝再生的影响,为临床脾亢治疗提供理论依据和新的思路。Hypersplenism is a common complication caused by liver cirrhosis and portal hypertension,and at present,splenectomy and partial splenic artery embolization(PSE)are the main methods for the treatment of hypersplenism.Splenectomy has a marked effect in the treatment of hypersplenism and can significantly improve the clinical symptoms of patients with hypersplenism.Compared with splenectomy,PSE causes partial splenic parenchymal infarction and thus achieve similar clinical efficacy as partial splenectomy while preserving the spleen and its function.Although PSE is an effective method for the treatment of hypersplenism,there are few reports on the effect of PSE on liver fibrosis,immunity,and liver regeneration in China and globally.This article summarizes the common causes of hypersplenism,the mechanism of PSE in the treatment of hypersplenism,the therapeutic effect of different embolization methods and materials,and the effect of PSE on liver fibrosis,immunity,and liver regeneration,so as to provide a theoretical basis and new ideas for the clinical treatment of hypersplenism.

关 键 词：肝硬化 高血压 门静脉 脾功能亢进 

分 类 号：R575.2[医药卫生—消化系统]