部分脾栓塞治疗儿童遗传性贫血的术后反应、并发症及其处理

Partial Splenic Embolization in the Treatment of Hereditary Anemia in Children : Post-Embolization Reactions and Complications

对１０６例地中海贫血和遗传性球形红细胞增多症患儿行部分性脾栓塞（ＰＳＥ）治疗。栓塞范围在５０％～８５％。其术后反应包括发热（９５％）、上腹痛（９５％）和恶心呕吐（５５％），一般在３～１０天自行消失。持续性高热往往提示大面积的脾坏死或液化坏死。并发症的发生率为１７．９％，包括脾液化坏死（１２例，占６０％），一过性高血压（３例，１６％），肺炎（２例，１１％），急性胰腺炎（１例，６％）和机械性肠梗阻（１例，６％）。其中较大的液化坏死采用经皮穿刺引流治疗。所有并发症均痊愈，本组无死亡及严重后遗症病例。作者认为ＰＳＥ对儿童遗传性贫血是安全的疗法。

Partial splenic embolization (PSE) was used to treat hereditary anemia in 106 chil-dren, including thalassemia major and hereditary spherocytosis, The embolization of spleen ranged from 50% to 85% , The post-pSE reactions included fever (95%), upper abdominal pain (95%)and nausea (55%). Generally, the symptoms disapeared in 3～10 days. Persistent high fever probably is a forewarning of a large area of splenic necrosis or liquefied necrosis, Incidence of the complications was 17.9% , including splenic necrosis (12 cases, 60% ), transient hypertension (3 cases, 16% )pneumonia(2 cases,11% ), acute pancreatitis ( 1 case, 6% ), and mechanical intesinal obstruction(1 case, 6% ). Liquefied necrosis was treated by percutaneous drainage. All the complications were cured without fatality or severe sequalae. It is believed that PSE is a safe therapy for children with hereditary anemia.