部分脾栓塞治疗血吸虫性脾功能亢进17例报告

Partial splenic embolization in the treatment of schistosomial hypersplenism: Report of 17 cases

目的探讨部分脾栓塞治疗血吸虫性脾功能亢进的临床价值. 方法对血吸虫性脾功能亢进17例行周围性部分脾栓塞,栓塞剂为医用明胶海绵. 结果栓塞范围50%～75%(平均59.0%).术后17例随访6～29个月,平均16.9月.白细胞计数术后最后一次随访为(5.74±1.31)×109/L,比术前(2.19±0.73)×109/L显著升高(t=11.86,P=0.000);血小板计数术后最后一次随访为(106.18±30.92)×109/L,比术前(31.29±14.09)×109/L显著升高(t=8.28,P=0.000).未出现严重并发症. 结论部分脾栓塞治疗血吸虫性脾功能亢进安全、疗效确切,但其远期疗效需进一步观察.

Objective To discuss the clinical value of partial splenic embolization in the treatment of schistosomial hypersplenism. Methods Peripheral partial splenic embolization using gelatin sponge (gelfoam) was performed in 17 cases of schistosomial hypersplenism. Results The amount of devascularized parenchyma was 50%~75% (mean, 59%). Postoperative follow-up was conducted for 6~29 months (mean, 16.9 months) in all the 17 cases. The leucocyte count was elevated significantly on the latest follow-up (5.74±1.31×109/L), as compared with the preoperative value (2.19±0.73×109/L) (t=11.86,P=0.000). The platelet count was significantly higher on the latest follow-up (106.18±30.92 ×109/L) than before the embolization (31.29±14.09×109/L) (t=8.28,P=0.000). No severe complications were seen. Conclusions Partial splenic embolization in the treatment of schistosomial hypersplenism is safe and effective, but its long-term effects remain a question to be answered through further research.