部分性脾栓塞在肿瘤相关假性肝硬化所致血小板减少症患者中的应用  

Partial splenic embolism for cancer patients with pseudocirrhosis induced thrombocytopenia

作　　者：杨柏帅 梁立 严俊 袁敏 YANG Boshuai;LIANG Li;YAN Jun;YUAN Min(Department of Interventional Radiology,Shanghai Public Health Clinical Center,Fudan University,Shanghai,201508,China;Department of Oncology,Zhongshan Hospital Affiliated to Fudan University;Department of Oncology,Central Hospital of Jiading District)

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心介入科,上海201508 [2]复旦大学附属中山医院肿瘤内科 [3]上海市嘉定区中心医院肿瘤科

出　　处：《中国中西医结合消化杂志》2024年第12期1077-1081,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:部分性脾栓塞(partial splenic embolization,PSE)可用于各种肝病引起的脾功能亢进,本研究旨在回顾小结PSE对肿瘤相关假性肝硬化所致血小板减少症(pseudocirrhosis induced thrombocytopenia,PIT)患者的有效性及安全性。方法:回顾性分析2023年1月—2024年10月确诊为PIT并因需继续系统抗肿瘤治疗而行PSE的患者9例,记录患者资料、病史、检查结果及不良反应。研究主要终点为患者外周血血小板计数大于100×10^(9)/L,次要终点为患者接受再次系统抗肿瘤治疗。结果:9例肿瘤相关PIT患者均接受单次PSE(男5例,女4例,年龄34~72岁,平均57.8岁),技术成功率为100%。所有患者均达到了主要和次要研究终点。平均血小板计数从术前最低(36.67±13.96)×10^(9)/L显著增加至(132.22±31.00)×10^(9)/L的峰值水平,术后1周、1个月平均血小板计数分别为(74.44±23.26)×10^(9)/L和(118.67±17.97)×10^(9)/L。9例患者均接受再次系统抗肿瘤治疗,7例(78%)在术后1个月内进行。未发生非靶器官栓塞,1例患者出现3级不良反应,总胆红素上升至131μmol/L,考虑与其合并胆囊结石相关。所有患者均出现轻至中度栓塞后综合征,对症治疗后可缓解。结论:对于肿瘤相关PIT患者,PSE是一种安全有效的治疗方式,有助于患者恢复血小板计数,并继续行系统抗肿瘤治疗。Objective:Partial splenic embolism(PSE)has been safely and widely used for hypersplenism caused by various liver diseases.The purpose of this study was to review and summarize the effectiveness and safety of PSE in cancer patients with pseudocirrhosis induced thrombocytopenia(PIT).Methods:A total of 9 patients diagnosed with PIT and undergoing PSE due to the need for continued systemic anti-tumor therapy from January 2023 to October 2024 were retrospectively analyzed.Clinical data,medical history,examination results,and adverse events of patients were recorded.The primary endpoint of the study included a platelet count increase>100×10^(9)/L,and the secondary endpoint was the initiation of systemic anti-tumor therapy.Results:PSE was performed in 9 patients with tumor related PIT(5 males,4 females;aged 34-72 years,with an average of 57.8 years),and the technical success rate was 100%.Primary and secondary endpoints were achieved in all patients.The mean platelet count significantly increased from(36.67±13.96)×10^(9)/L before PSE to a peak level of(132.22±31.00)×10^(9)/L.The mean platelet counts at 1 week and 1 month after PSE were(74.44±23.26)×10^(9)/L and(118.67±17.97)×10^(9)/L respectively.All patients could receive systemic anti-tumor therapy once again,with 7 patients(78%)within 1 month after surgery.No non-target embolization occurred,and one patient experienced a grade 3 adverse event with an increase in total bilirubin to 131μmol/L due to his gallstones.All patients experienced a mild to moderate postembolization syndrome,which can be relieved with supportive treatment.Conclusion:PSE is a safe and effective treatment for cancer patients with PIT.The platelet count is restored and patients are able to continue systematic anti-tumor treatment.

关 键 词：脾功能亢进 假性肝硬化 部分性脾栓塞 肿瘤治疗所致血小板减少症 假性肝硬化所致血小板减少症 

分 类 号：R575[医药卫生—消化系统]