部分脾动脉栓塞术治疗原发性肝癌合并脾功能亢进的临床疗效观察

Observation on the Clinical Efficiency of Partial Artery Embolization in Treating Primary Liver Cancer combined with Hypersplenism

目的：探讨部分性脾动脉栓塞术（PSE）治疗原发性肝癌合并脾功能亢进的临床疗效及安全性。方法：选择2008年5月至2013年4月我科收治的160例原发性肝癌合并有脾功亢进患者为研究对象,患者在行肝动脉化疗栓塞术（TACE）的同时进行PSE,PSE栓塞面积在30%~60%之间,观察治疗后3天、7天、1个月、3个月、6个月患者白细胞（WBC）计数和血小板（PLT）计数的动态变化情况。结果：以外周血白细胞计数达到4.0~13×109/L、血小板达计数到50×109/L为治疗有效,160例患者术后3个月时外周血白细胞治疗有效为151例（94.38%）,血小板治疗有效为155例（96.88%）,术后6个月时白细胞治疗有效136例（85%）,血小板治疗有效125例（78.13%）。所有患者术后6个月均未发生严重并发症。结论：PSE联合TACE治疗原发性肝癌合并有脾功亢进患者具有良好的疗效,且安全性较高。

Objective： To investigate the clinical efficiency of partial splenic artery embolization in treating primary hepaticarcinoma with hypersplenism. Methods： From Jan 2008 to Oct 2013, 160 cases of hepatocellular carcinoma with hypersplenism treated with transcatheter artery chemoembolization（TACE） combined with partial splenic artery embolization（PSE）. The embolism area of PSE was30% -60%, the WBC and PLT count were observed before treatment and 3 d, 7 d, 1 M, 3 M, 6 M after embolization. Results： WBC4.0-13×10 9/L and PLT 50×10 9/L were considered to be effective. On 3 months, 152 cases（94.38%） were effective in WBC and 155cases（96.88%） in PLT. On 6 months, 136 cases（85%） were effective in WBC and 125 cases（78.13%） in PLT. No serious complication was observed. Conclusions： PSE with TACE was safe and effective for hepatocellular carcinoma with hypersplenism.