原发性肝癌伴脾亢的介入治疗(附31例报告)  

Interventional Therapy for Primary Hepatocarcinoma Concurred with Hypersplenism(A Report of 31 Cases)

作　　者：戴社教[1] 周斌[1] 刘振堂[1] 彭玉萍[1] 张亚红[1] 程丽丽[1] 徐光[1] 南岩东[1] 

机构地区：[1]西安交通大学第二医院放射科,陕西西安710004

出　　处：《实用放射学杂志》2003年第5期443-445,共3页Journal of Practical Radiology

摘　　要：目的　探讨肝动脉化疗栓塞联合部分性脾动脉栓塞 (PSE)治疗原发性肝癌合并脾功能亢进的意义及方法。方法　原发性肝癌合并脾亢 3 1例 ,采用经皮穿刺肝动脉化疗栓塞术 (TACE)和PSE治疗 ,治疗前后测定血细胞数量 ,CT观察肝脏肿瘤及脾脏大小改变。结果　PSE术后 2 4h、1周、4周血白细胞和血小板均较栓塞前明显升高 (Ρ <0 .0 1)。 2 8例脾栓塞面积在 40 %～70 % ,2例 80 % ,1例 <40 %。术后 1月CT复查肝脏肿瘤缩小 2 2例 ,占 70 .97% (2 2 / 3 1)。脾脏有所缩小 ,内可见均一低密度梗死区。结论　肝动脉化疗栓塞及部分性脾动脉栓塞是治疗肝癌合并肝硬化脾功能亢进安全。Objective To study the effect and method of transcatheter hepatic arterial chemoembolization (TACE) combined with partial splenic embolization (PSE) for treatment of liver cancer with portal hypertension and hypersplenism. Methods TACE combined with PSE was performed in 31 patiens with hepatocellular carcinoma complicated with portal hypertension and hypersplenism.The blood cell count was examined both before and after embolization.Results Comparised with pre-embolization a significant increase in the peripheral leukocyte and platelet count was found from 24 hours to 4 weeks after the embolization. 40%～70% of splenic parenchyma was infarcted in 28 patients. Reviewed CT 1 month postoperation showed 22 cases' liver cancer shrinked, occuping 70.97%(22/31). Spleen reduced partially and the necrotic area showed well-distributed lower density state.Conclusion TACE combined with PSE is a safe and effective procedure for patients with hepatocellular carcinoma associated with liver cirrhosis, portal hypertension and hypersplenism.

关 键 词：原发性肝癌 介入治疗 脾功能亢进 合并症 经皮穿刺肝动脉化疗栓塞术 部分性脾动脉栓塞 

分 类 号：R735.7[医药卫生—肿瘤] R657.63[医药卫生—临床医学]