部分性脾动脉栓塞治疗103例肝硬化脾机能亢进的疗效观察

Clinic evaluation of partial splenic embolization on 103 cases of hepatic cirrhosis with hypersplenism

目的研究用部分脾动脉栓塞方法治疗脾机能亢进的临床效果。方法采用Seldinger方法,选择103例脾机能亢进患者,经股动脉穿刺,将导管选择性进入脾动脉,经导管注入明胶海棉,阻断部分脾动脉。治疗后1周、术后4周及6个月观察随诊脾静脉宽度、脾脏厚度及外周血象的变化。结论脾动脉部分栓塞术既能减少脾脏血流,降低门静脉压力,减轻食管静脉曲张,可以改善脾功能亢进所致的外周血象改变,同时又保留了脾脏免疫功能。

[Objective] To assess the clinical effects of partial splenic embolization （PSE） in the treatment of hepatic cirrhosis with hypersplenism, [Methods] 103 cases with perslenism were studied. Using Seldinger＇s method, the catheter was inserted into splenic artery and then granules or tiny strips of gelfoam was injected through the catheter. Peripheral blood cell＇ acount and splenic vein＇ widen and the splenic thick were observed after treatment in 1 weeks and 4 weeks and 6 months, [Resultsl The peripheral blood cell＇ acount were significantly increased （P 〈 0.001）, The inner diameter of splenic vein were significantly narrow （P 〈0.001）, the splenic thick were significantly thinner （P 〈0.001）, [Conclusion] PSE can not only treat hypersplenism but also decrease portal vein pressure, at the same time maintain splenic immunity.