部分性脾栓塞术62例术后并发症原因分析及防治措施探讨

Discussion on the Cause of Compl ications and Prophylactico-therapeutic Measures in 62 Cases after PSE

目的 探讨部分性脾栓塞(PSE)治疗脾亢的术后并发症及其预防、处理。方法 6 2例各种原因所致的脾亢患者,采用Seldinger技术,用明胶海绵颗粒或/和明胶海绵条行PSE。结果 技术成功率10 0 % ,术后发热、腹痛6 2例,恶心、呕吐30例,穿刺部分血肿7例,肝功损害加重5例,肝功一过性损害2 2例。栓塞面积4 0 %～70 % 5 4例,15例出现少量胸水,1例少量胸水伴左下肺炎,栓塞面积70 %以上8例,4例出现较严重的并发症。结论 PSE治疗脾亢安全、疗效肯定,术后综合症常见,经一般对症处理好转;只要病例选择适当,技术操作熟练,栓塞面积恰当,严重并发症少见。

Objective To discuss the complications and prophylact ico-therapeutic measures after PSE as th e treatment to hypersplenia.Methods Splenic embolizati on with the Seldinger technique was give n to 62 patients of hypersplenia with va rious causes.Results The successful rat e reached 100%.After operation,62 cases had fever and abdominal pain,30 cases ha d nauseating and vomiting;hematoma in pu ncture site occurred in 7 cases,sever he patic function failure in 5 cases,transi ent injury of hepatic function in 22 cas es.Out of the 54 cases with embolizaton area over 40% to 70%,15 cases showed a l ittle hydrothorax and 1 case showed a li ttle hydrothorax with pneumonia of left lower lung;out of the 8 cases with embol ization area over 70%,4 cases suffered f rom severe complications.Conclusions It is safe and of certain curative effect to treat hype rsplenia with PSE,the common syndrome af ter operation may be cured with symptoma tic treatment;the severe complications w i ll seldom occur with correct selection o f cases,skillful performance and proper embolization area.