原发性肝癌伴门脉高压的肝脾联合栓塞对肝功能的影响

The effect of TACE plus PSE on the liver function of hepatic cancer with portal hypertension and hypersplenism

目的 分析经导管肝动脉化疗栓塞术 (TACE)及部分脾栓塞术 (PSE)联合治疗对原发性肝癌 (HCC)患者的肝功能影响。方法 原发性肝癌合并门脉高压及脾功能亢进患者 85例 ,4 5例经TACE及PSE联合治疗 ,4 0例单纯行TACE治疗。治疗前后观察肝功能指标及Child Pugh评分变化。结果 术前 ,A、B两组患者的TBIL、ALT、ALB及Child Pugh评分比较无明显差异 (P >0 .0 5 ) ,术后 1周与术前比较 ,两组均有显著性差异 (P <0 .0 5、P <0 .0 1) ;长期观察 ,TACE加PSE组治疗前后肝功能改善较单纯TACE组明显。结论 TACE联合PSE是治疗肝癌合并门脉高压及脾亢患者安全、有效的方法。

Objective To evaluate the effect of transcatheter arterial chemoembolization (TACE) plus partial spleen embolization (PSE) on the liver function in patients with hepatocellular carcinoma (HCC). Methods 85 patients with HCC complicated with portal hypertension and hypersplenism, including group A 45 patients with treatment of TACE plus PSE and group B 40 patients with single TACE were observed. The liver function was evaluated with Child Pugh scores before and after the procedure. Results There was no difference in the levels of TBIL、ALT、ALB and Child Pugh scores between groups A and B (P>0.05) but remarkable change after therapy was shown at one week later (P<0.05,P<0.01). The liver function tests showed remarkable improvement in the TACE plus PSE group. Conclusion TACE combined with PSE is a safe and effective procedure for patients with HCC associated with liver cirrhosis, portal hypertension and hypersplenism.