部分性脾栓塞治疗脾功能亢进

Partly splenic embolism in the treatment of hypersplenism

目的研究部分性脾栓塞治疗脾功能亢进的临床价值。方法对27例脾功能亢进患者行周围性部分性脾栓塞,栓塞剂为明胶海绵,以明胶海绵与脾动脉分支关系公式得出的明胶海绵颗粒数为基础,术中多次造影分次追加控制栓塞面积,栓塞前后测定血细胞数量。结果2例青年Child分级A级患者栓塞了75%,6例肝癌伴脾亢者为40%左右,其余均在50%～60%之间。术后24h、72h、1周、2周、4周、3个月、6个月复查血白细胞和血小板均较栓塞前明显升高(P<0.05),未出现严重并发症。结论部分性脾栓塞治疗脾功能亢进安全、显效、并发症少。术中多次造影分次追加能防止过度栓塞和栓塞不足,减轻并发症。

Objective To evaluate the clinical valuation of partly splenic embolism in the treatment of hypersplenism. Methods All the twenty-seven patiens with hypersplenism was given peripheral partly splenic embolism, the embolus was gelatin, the dosage of gelfoam granule was on the basis of the formation of gelatin and splenic artery branch. Intraoperative, multiple splenic artery angiography was needed, so there was a proper dosage of gelfoam granule to control the area ,of splenic embolism, pre-and post-splenic embolism, we investigate the blood ratine, especially the count of .WBC and PLT. Results The area of splenic embolism in 2 young patients with liver function Child A was 75%, in 6 primary liver tumor with hypersplenism was about 40% , and the other＇ s area of splenic embolism was 50% -60%. Post-operative 24 h,72 h, 1 week,2 weeks,4 weeks,3 months, 6 months, the counts of WBC and PLT elevated obvious compared preoperative（ P 〈0. 05 ）, and have no complications. Conclusion Partly splenic embolism in the treatment of hypersplenism is safety effective almost no complication, intraoperative, multiple splenic artery angiography could control the area of splenic embolism, preventing the inappropriate embolism, decreasing complications.