脾动脉部分栓塞联合肝动脉化疗栓塞治疗原发性肝细胞癌合并脾亢的临床研究

Study on Primary Hepatocellular Carcinoma Associated with Hypersplenism Treated by Partial Splenic Embolization Combined with Hepatic Arterial Chemoembolization

背景与目的:原发性肝细胞癌(primaryhepatocellularcarcinoma,PHC)患者70%～90%伴有肝硬化、脾功能亢进以致患者术前外周血象偏低或术后外周血象恢复缓慢常影响经肝动脉化疗栓塞(transcatheterhepaticarterialchemoembolization,TACE)的正常进行。本研究探讨脾动脉部分栓塞(partialsplenicembolization,PSE)联合经TACE治疗合并脾功能亢进的PHC的方法和意义。方法:对26例PHC患者采用PSE联合TACE治疗的方法,26例PHC患者单用TACE治疗。结果:PSE联合TACE较单用TACE治疗明显改善PHC患者外周血象,PSE术后3天、1周、2周及4周外周血白细胞、红细胞、血小板较栓塞前明显提高。结论:PSE联合TACE是PHC合并脾亢的安全、有效治疗方法。

BACKGROUND ＆ OBJECTIVE： 70-90% of patients of primary hepatocellular carcinoma （PHC） are associated with liver cirrhosis, portal hypertention and hypersplenism. The treatment of PHC is usually hampered by low or slow recovery of blood cell counts. This study was to investigate the effect of partial splenic embolization （PSE） combined with transcatheter hepatic arterial chemoembolization （TACE） for the treatment of PHC with portal hypertention and hypersplenism. METHODS. Efficacy of 26 patients with PSE combined with TACE and 26 patients with single TACE was observed. RESULTS. Satisfactory effects were achieved in PSE combined with TACE group in terms of correction of blood cell counts compared with cases treated with TACE alone. CONCLUSION： PSE associated with TACE is safe and effective for the treatment of patients with PHC associated with liver cirrhosis, portal hypertention and hypersplenism.