部分性脾动脉栓塞术在治疗脾功能亢进中的应用

Application of partial splenic embolization in the treatment of hypersplenism

目的探讨部分性脾动脉栓塞在治疗脾功能亢进中的临床疗效及安全性。方法对16例脾功能亢进患者用明胶海绵碎屑、碘油、平阳霉素进行脾动脉部分栓塞,栓塞面积约70%,并于术后第3天、第10天、1个月、3个月、6个月复查血细胞的变化,第1、3、6个月进行脾脏CT扫描。结果15例于第3天复查,显示外周血白细胞和血小板开始回升,14例3个月内达到或接近正常值,16例1～3个月CT复查脾实质均可见囊变坏死灶,14例脾脏体积缩小,以术后第3～6个月最为明显;术后常见并发症主要有发热、肺部感染和少量胸腔积液。结论部分性脾动脉栓塞范围控制在70%时,是一种安全、有效的脾功能亢进治疗方法。

Objective To investigate the efficacy and safety of partial splenic embolization（PSE） in the treatment of hypersplenism. Methods Sixteen patients with hypersplenism received PSE in which Gelatin sponge, Iodized oil and Pingyangmycin were choosed as embolization materials. The area of embolization was around 70%. After operation, the blood routine examination was carried out on the 3rd, 10th day, 1 st,3rd and 6th month, respectively. CT scan of spleens were performed in the 1 st ,3rd and 6th month, respectively. Results WBC and PLT began to increase in 15 cases on the 3rd day after operation,and reached to a normal level in 14 cases in the following 3 months. Necrosis was found in spleen parenchyma in all cases by CT scan in 1-3 months. The volume of spleen decreased significantly in 14 cases 3-6 months after operation. The common complications of PSE were fever, pneumonia and pleural effusion. Conchtslon PSE is a safe and effective therapy for hypersplenism when the area of embolization is limited to about 70%.