肝动脉及部分脾动脉栓塞治疗肝癌伴脾功能亢进

Hepatic artery and partial splenic artery embolization therapy of liver cancer concurred hypersplenism

目的 观察采用肝动脉栓塞化疗联合部分脾动脉栓塞治疗原发性肝癌合并脾功能亢进的疗效。方法 原发性肝癌伴肝硬化脾功能亢进患者３４ 例，采用经皮穿刺肝动脉插管化疗栓塞及脾动脉部分栓塞治疗，治疗前后测肝功、免疫指标、外周血及Ｂ 超、ＣＴ 等。结果 术后ＣＴ 随访显示肝脏瘤体缩小２４ 例，占７０－５８ ％ （２４／３４） ，其中缩小５０ ％ 以上占１３ 例，２ 例治疗后行二期手术切除；脾脏栓塞后ＣＴ 复查缩小最大３４－７ ％ ，最小２０－６ ％ ，治疗后ＡＦＰ 有不同程度下降，有２３例治疗后肝功能改善，免疫指标治疗前后无大变化，动态监测治疗后外周血象，ＷＢＣ、ＲＢＣ、ＰＴ 均有提高，其中ＰＴ 明显升高（Ｐ＜ ０－０１） 。结论 肝动脉及部分脾动脉栓塞伴化疗可使肝肿瘤缩小，脾功能亢进缓解。

Aim To observe therapeutic effectiveness of combined chemocmbolization of hepatic artery and partial splenic artery in the primary liver cancer concurred hypersplenism.Methods There were 34 in-patients of primary liver cancer concurred cirrhosis and hypersplenism.They were given percutaneous puncurt of liver artery and heptic artery and partial splenic artery embolization combined with chemotherapy.Several tests were done including liver function,immune index blood routine,B-US and CT.Result Following up by CT after operation showed that 24 cases′ liver tumor(70 58%,24/34) shrinked,OF them 13 cases shrinked more than 50%.2 cases had secondary operation after treatment.After embolism,spleen shrinked by checking CT.The most one was 34.7% and the least one was 20.0%.AFP declined with different effect.23 cases′ liver function improved.Immune index had no change before and after treatment.WBC,RBC,and PT all developed by dynamic observation of blood routine.Especially PT elevated significantly after treatment (P<0.01).Conclusion Embolizing liver artery and patrial splenic artery combined with chemotherapy can shrink liver tumor,remit hypersplenism.So it was an effective method to treat medium and late stage liver cancer.