部分脾动脉栓塞术治疗肝硬化脾功能亢进近期与远期疗效观察  

Short-term and long-term efficacy of partial splenic artery embolization in the treatment of cirrhosis with hypersplenism

作　　者：占魁 张天佑 黄水根 欧书强 辛力 邬飞源 邱艳 张宁 ZHAN Kui;ZHANG Tianyou;HUANG Shuigen;OU Shuqiang;XIN Li;WU Feiyuan;QIU Yan;ZHANG Ning(Department of Hepatology,Pingxiang No.2 People’s Hospital,Pingxiang,Jiangxi Province 337000,China)

机构地区：[1]萍乡市第二人民医院肝病科,江西萍乡337000

出　　处：《实用放射学杂志》2025年第3期482-485,共4页Journal of Practical Radiology

摘　　要：目的 探讨部分脾动脉栓塞术(PSE)治疗肝硬化脾功能亢进近期与远期疗效对比.方法 回顾性分析因肝硬化脾功能亢进行PSE治疗的35例患者,收集术前、术后1周、术后1年白细胞(WBC)、红细胞(RBC)、血小板计数(PLT)、血红蛋白(HGB)、总胆红素(TBiL)、白蛋白(ALB)、凝血酶原时间(PT)、D-二聚体3组数据,观察比较3组变化情况,使用单因素重复测量方差分析,并对3组时间两两比较.根据患者术后是否形成门脉血栓,分为血栓组和无血栓组,对术前、术后1周D-二聚体数值进行比较.结果 WBC、PLT术后1周、术后1年较术前均有明显升高,术后1周升高最为明显,术后1周与术后1年比较同样存在统计学意义(P1,P2,P3<0.05);RBC、HGB术后1周与术前比较无显著差异(RBC P1=0.835,HGB P1=0.446),但术后1年RBC、HGB较术前、术后1周均显著升高(RBC P2=0.039,P3=0.015;HGB P2=0.001,P3=0.010).术后1周TBiL、ALB、PT、D-二聚体较术前均有显著差异(TBiL P1=0.006,ALB P1<0.001,PT P1=0.001,D-二聚体P1<0.001),但术后1年与术前比较无统计学意义(P2均>0.05).血栓组术后1周D-二聚体明显高于无血栓组,差异有统计学意义(P=0.024),2组术前D-二聚体无显著差异.结论 PSE治疗肝硬化脾功能亢进,术后 WBC、PLT无论近期还是远期疗效肯定.RBC、HGB近期上升不明显,但远期疗效显著.术后近期出现TBiL上升、ALB下降、PT延长肝脏储备功能下降,但远期无影响.术后D-二聚体上升,容易诱发门脉血栓,术后近期内可予以抗凝治疗.Objective To explore the short-term and long-term efficacy of partial splenic artery embolization(PSE)in the treatment of cirrhosis with hypersplenism.Methods A retrospective analysis was conducted on 35 patients with cirrhosis and hypersplenism who underwent PSE treatment.Data on white blood cell(WBC),red blood cell(RBC),platelet count(PLT),hemoglobin(HGB),total bilirubin(TBiL),albumin(ALB),prothrombin time(PT),and D-dimer were collected at the three time points:before surgery,1 week after surgery,and 1 year after surgery.The changes in these parameters across the three time points were observed and compared.One-way ANOVA was used for repeated measurements,and time pairwise comparisons were made between the three time points.According to the formation of portal thrombosis,patients were divided into thrombus group and no-thrombus group.The D-dimer values were compared before surgery and 1 week after surgery.Results WBC and PLT were significantly higher 1 week and 1 year after surgery than those before surgery,with the most significant increase 1 week after surgery,and there was also statistically significant difference between 1 week after surgery and 1 year after surgery(P1,P2,P3<0.05).There were no significant differences in RBC and HGB between 1 week after surgery and before surgery(RBC P1=0.835,HGB P1=0.446).However,RBC and HGB 1 year after surgery were significantly higher than those before surgery and 1 week after surgery(RBC P2=0.039,P3=0.015;HGB P2=0.001,P3=0.010).There were significant differences in TBiL,ALB,PT,and D-dimer 1 week after surgery compared with those before surgery(TBiL P1=0.006,ALB P1<0.001,PT P1=0.001,D-dimer P1<0.001),but there was no significant difference between 1 year after surgery and before surgery(all P2>0.05).The D-dimer of the thrombus group was significantly higher than that of the no-thrombus group 1 week after surgery,with a statistical significance(P=0.024),however,there was no significant difference in D-dimer between the two groups before surgery.Conclusion PSE in the trea

关 键 词：肝硬化 脾功能亢进 部分脾动脉栓塞术 疗效 

分 类 号：R575.2[医药卫生—消化系统] R551.1[医药卫生—内科学] R815[医药卫生—临床医学]