部分脾栓塞术的临床应用

Clinical application of partial splenic embolization

目的 探讨部分脾栓塞术 (PSE)的临床应用。方法 采用PSE治疗肝癌伴脾亢 (HCC HS) 86例 ,其它继发性脾亢 (SHS) 2 6例 ,原发性血小板减少性紫癜 (ITP) 5例 ,其中 2 0例行 2次以上PSE。结果 平均栓塞范围HCC HS组为 36 % ,SHS组为 6 0 % ,ITP组为 74% ,临床有效率分别为84.8%、88.5 %、10 0 %。HCC HS组因单次栓塞范围较小 ,约 2 0 .9% (18/ 86 )病人需行再次栓塞。全部病例均未发生严重并发症。结论 PSE是安全有效的 ,可作为外科脾切除的替代疗法。HCC HS组为了减轻术后并发症PSE可分次进行。

Objective To probe the clinical application of partial splenic embolization (PSE).Methods 86 cases of hepatocellular carcinoma with hypersplenism (HCC HS), 26 cases of secondary hypersplenism(SHS) and 5 cases of idiopathic thrombocytopenic purpura(ITP) have been treated by PSE. Results The average extents of HCC HS, SHS and ITP embolization were 36%, 60%, 74% respectively, and the clinical effective rates were 84.8%、88.5%、100% respectively. Because of the extent of once embolization was too small in the HCC HS group, 20.9% (18/86) patients had to be treated again by PSE. No severe complication occurred in all cases. Conclusion PSE is a safe and effective therapy, and it could take the place of surgical splenectomy under certain condition as indicated. To decrease complication of postoperative HCC HS patients, the PSE should be carried out twice or more.