部分脾栓塞术的临床应用

CLINICAL APPLICATION OF PARTIAL SPLENIC EMBOLIZATION

目的探讨部分脾栓塞术(PSE)的临床应用。方法采用PSE治疗肝癌伴脾亢(HCC—HS)86例,其它继发性脾亢(SHS)26例,原发性血小板减少性紫癜(ITP)5例,其中20例行2次以上PSE。结果平均栓塞范围HCC—HS组为36%,SHS 组为60%,ITP 组为74%,临床有效率分别为84.8%、88.5、100%。HCC—HS组因单次栓塞范围较小,约20.9%(18/86)病人需行再次栓塞。全部病例均未发生严重并发症。结论PSE是安全有效的,可作为外科脾切除的替代疗法。HCC—HS组为减轻术后并发症PSE可分次进行。

Objective To Proto into the clinical application of partialsplenic embolization(PSE).Methods 86 cases of hepatocellu-lar carcinoma with hyparsplenism(HCC-HS),26 cases of subseguent hyparsplenism(SHS)end 5 cases of idiopathic thrombocytopenicpurpura(ITP)have been treated by PSE.Results The average extent of embolization was 36%,60%,74% respectively,and the clinicaleffective rate was 84.8%、88.5%、100% respectively.Because of the extent of once embolization was small in the HCC-HS group,20.9%(18/86)patients would he treated again by PSE.No severe complication occurred in all cases.Conclusions The PSE is a safe andeffective therapy,and it could take the place of surgical splenectomy under certain condition as indicated.To decrease complication ofpostoperation of HCC-HS patients,the PSE could be carried out twice or more.