部分性脾栓塞治疗脾功能亢进

Partial splenic embolizaoion in the treatment of hypersplenism

目的 :探讨部分性脾栓塞 (PSE)治疗脾功能亢进的临床应用价值及脾栓塞范围与疗效关系。方法 :4 8例脾功能亢进患者随机分为两组 ,第 1组 16例 ,脾栓塞范围 4 0 %～ 5 9% ;第 2组 32例 ,脾栓塞范围 6 0 %～ 80 % ,并随访 1年。结果 :血小板计数第 1,2组近期缓解 (CR +PR)有效率分别为 81.3%、93.8% ;远期缓解有效率分别为 6 2 .5 %、87.5 % ;1年复发率分别为 2 3.1%、6 .7%。白细胞计数第 1,2组远期缓解有效率分别为 71.4 %、82 .2 % ;1年复发率分别为 2 8.6 %、17 8%。红细胞计数第 1,2组远期缓解有效率分别为 70 %、83.3% ,1年复发率分别为 2 2 .2 %、11.8%。结论 :PSE治疗脾功能亢进疗效好。脾栓塞范围以 6 0 %～ 80 %为佳 ,复发率低。

Objective:To study the clinical significance of partial splenic embolization (PSE) in the treatment of hypersplenism and the relationship between the therapeutic effect and the area of embolization.Methods:48 patients with hypersplenism were divided into two random groups:one with 16 cases and the other with 32 cases.The embolization area of the first group was 40%～59% and that of the second one was 60%～80%.All patients were called on a year.Results:The short term effective rates (CR+PR) of thrombocyte count were 81.3% in the first group and 93.8% in the second group,whereas the long term effective rates were 62.5% and 87.5% respectively.The corresponding one year recurrent rates were 23.1% and 6.7%.The long term effective rates of WBC count were 71.4% in the first group and 82.2% in the second group,with one year recurrent rate of 28.6% and 17.8% respectively.The long term effective rates of RBC count were 70% in the first group and 83.3% in the second group,with one year recurrent rate of 22.2% and 11.8% respectively.Conclusion:PSE is effective in treating hypersplenism.When the embolization area is between 60% to 80%,the therapeutic effect is better with a low recurrent rate.