经皮射频消融治疗脾功能亢进症

Percutaneous radiofrequency ablation of spleen for the treatment of hypersplenism

目的总结CT导向下冷循环射频消融(RFA)治疗肝硬化门脉高压性脾功能亢进症(脾亢)的效果和经验。方法采用CT导向下冷循环RFA治疗15例脾亢患者,术前血小板计数(PLT)为(62.0±9.8)×109/L,术后复查血常规和增强CT或MR。结果RFA毁损范围占脾脏总体积(31.0±4.6)%,术后1个月PLT为(96±11)×109/L,与术前相比显著增高(P<0.05),术后1例出现门静脉血栓形成,无其他严重并发症。结论CT导向下冷循环RFA治疗脾亢安全、有效。

Objective To summarize the clinical effect and experience of CT-guided radiofrequency ablation （RFA） of spleen by using cool-tip electrodes in the treatment of hypersplenism in patients with liver cirrhosis and portal hypertension. Methods CT-guided RFA of spleen by using cool-tip electrodes was performed in 15 patients with hypersplenism associated with liver cirrhosis and portal hypertension. The routine blood count was studied both before and after the procedure. Enhanced CT or MR scanning was reexamined after the treatment to determine the ablated volume of the spleen. The results were statistically analyzed. Results The ablated volume of the spleen accounted for （31.0 ± 4.6）% of the whole spleen.Before the treatment the platelet count was （62 ± 9.8）×10^9/L. One month after the treatment, the platelet count was increased to （96 ± 11 ）×10^9/L, which was significantly higher than that before the treatment （P 〈 0.05）. One patient developed portal thrombosis four months after RFA, and no other serious complications occurred. Conclusion CT-guided radiofrequency ablation of spleen by using cool-tip electrodes is an effective and safe treatment for hypersplenism in patients with liver cirrhosis and portal hypertension.