部分脾动脉栓塞术的临床应用

Clinical Application of Partial Splenic Embolization

目的探讨部分脾动脉栓塞术治疗门静脉高压并发脾功能亢进、原发性血小板减少性紫癜、骨髓增生异常综合征、自身免疫性溶血性贫血的新方法和疗效。方法对 20例(男13例,女,7例)患者在数字减影血管造影(DSA)下行经皮股动脉穿刺,先行脾动脉造影,然后超选择行脾动脉栓塞至血流明显减少为止。结果 2个月后复查血象,白细胞(WBC)、血小板(PLT)均有显著提高,血色素(HGB)亦有所提高,1个月后 B 超提示脾脏体积缩小。结论部分脾动脉栓塞术,损伤小、疗效明显、安全可靠、并发症少,是一种可行的保守治疗,同时又能保留脾脏的免疫功能,值得推广。

Objective To evaluate the effect of partial splenic artery embolization for patients with portal hypertension with hypersplenism, primary, thrombocytopenia purpura, myelodysplastic syndrome and autoimmune hemolytic anemia. Methods Angiography of splenic artery was done by percutaneous femoral artery puncture by DSA for 20 patients （ male 13, fencale 7）. Then partial splenic artery was embolized so that the blood flows decreased obviously. Results Two months later, WBC and platelet count increased significantly, and hemoglobin increased mildly. B ultrasound examination showed the spleen shrunk after one month. Conclusion Partial splenic embolization has a minor wound and good curative effect. It is a safe and few complication operation. At the same time it can retain spleen function, so it is a feasible conservative therapy and deserved to be popularized.