组织胶栓塞脾动脉治疗脾功能亢进的可行性  

Feasibility analysis of splenic artery embolization with cyanoacrylate glue in the treatment of hypersplenism

作　　者：孙占国 张程智 方毅[1] 刘一铭 许凯豪 韩新巍[1] 朱福霞 焦德超[1] SUN Zhanguo;ZHANG Chengzhi;FANG Yi;LIU Yiming;XU Kaihao;HAN Xinwei;ZHU Fuxia;JIAO Dechao(Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450050,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450050

出　　处：《实用放射学杂志》2023年第10期1678-1681,共4页Journal of Practical Radiology

摘　　要：目的探讨组织胶栓塞脾动脉治疗脾功能亢进(脾亢)的可行性。方法回顾分析17例肝硬化合并脾亢患者的临床资料,采用组织胶栓塞脾动脉以纠正脾亢,评价技术成功率、栓塞体积、并发症发生率及血小板(PLT)和白细胞(WBC)动态变化规律,比较术前、术后30 d PLT、WBC、谷丙转氨酶(ALT)、总胆红素(TBIL)的变化。结果本组患者技术成功率100%,脾栓塞比率平均为46.8%,轻微并发症发生率为29.4%,未见严重并发症发生。PLT和WBC均表现为逐渐升高,14 d达峰,30 d略降低。术前PLT和WBC分别为(20.2±5.8)×10^(9)/L和(1.3±0.4)×10^(9)/L,术后30 d为(103.1±14.3)×10^(9)/L和(3.8±0.6)×10^(9)/L,术前、术后比较差异有统计学意义(P<0.05),术前、术后30 d ALT[(35.8±12.9)U/L vs(31.5±8.2 U/L)]和TBIL[(17.3±7.2)μmol/L vs(16.3±6.9)μmol/L]比较差异均无统计学意义(P>0.05)。结论组织胶栓塞脾动脉治疗脾亢安全、可行、有效。Objective To explore the feasibility of splenic artery embolization with cyanoacrylate glue in the treatment of hypersplenism.Methods A total of 17 cirrhotic patients complicated with hypersplenism were treated with splenic artery embolization with cyanoacrylate glue in a single center.All clinical data were analyzed retrospectively,and the technical success rate,embolic volume,complications,dynamic changes of platelet(PLT),white blood cell(WBC)were further evaluated.Moreover,the alterations of PLT,WBC,alanine aminotransferase(ALT),and total bilirubin(TBIL)were compared before and 30 days after the operation.Results In this study,the technical success rate was 100%.The average rate of splenic embolism was 46.8%.The mild complications rate was 29.4%without major complications.PLT and WBC increased gradually,peaked at 14 days,and decreased slightly at 30 days.The levels of PLT and WBC were(20.2±5.8)×10^(9)/L and(1.3±0.4)×10^(9)/L before operation and(103.1±14.3)×10^(9)/L and(3.8±0.6)×10^(9)/L 30 days after the operation,respectively.There was statistically significant difference in the levels of PLT and WBC before and after surgery(P<0.05).There was no significant difference in ALT[(35.8±12.9)U/L vs(31.5±8.3)U/L]and TBIL[(17.3±7.2)μmol/L vs(16.3±6.9)μmol/L]before and 30 days after operation(P>0.05).Conclusion Embolization of the splenic artery with cyanoacrylate glue for hypersplenism is safe,feasible and effective.

关 键 词：脾功能亢进 部分脾动脉栓塞术 组织胶 

分 类 号：R551.1[医药卫生—血液循环系统疾病] R815[医药卫生—内科学]