部分性脾栓塞术治疗门脉高压性肝硬化脾亢的近期临床疗效

Evaluating the immediate effect of partial splenic embolization on the liver cirrhosis accompanied with hypersplenism

目的评价部分性脾栓塞术(PSE)的近期临床疗效及不良反应.方法对74例确诊为肝硬化脾功能亢进的患者,比较部分性脾栓塞术前术后血常规、肝功能、凝血酶原时间及术后并发症.结果部分性脾栓塞术后白细胞即有明显回升(P＜0.01),血小板缓慢回升,与术前相比差异有统计学意义(P＜0.05),但红细胞与术前相比变化不大(P＞0.05).部分性脾栓塞术后可出现脾包膜下血肿、上消化道出血、肝性脑病等严重并发症,栓塞面积在60%～80%之间时可取得较好的疗效且并发症发生无明显增加.结论部分性脾栓塞术治疗肝硬化脾亢,近期疗效明确,不良反应较少,应重视围手术期的处理.

Objective To evaluate the immediate effect and side effect of partial splenic embolization （PSE）.Methods For 74 cases of liver cirrhosis patients accompanied with hypersplenism, the liver function, blood routine, prothrombin time of before and aftersurgery and post surgery syndrome were compared. Results Peripheral blood routine of the liver cirrhosis patients accompanied with hypersplenism executed PSE were markedly improved, the account of white blood cells were significantly ascend post PSE （ P 〈 0.01）. The platelet account ascended slowly. There were significant ascent compared with pre - operation （ P 〈 0.05 ） , the account of platelet ascended slowly. But the red bloood cells account had no significant change（P〈0.05）.The post PSE syndromes included soplenic hypoenvelope hematoma, upper gastrointestinal hemorrhage, hepatic encephalopathy, etc. It can get better effect when the embolism area ranged from 60 % to 80 % and the syndrome didn＇t increase obviously at the same time. Conclusion The effects of PSE on the cirrhosis accom- panied with hypersplenism are significant and have little side effect. The management of perioperation should be paid attention.