PSE治疗肝硬化继发脾功能亢进的可行性分析

Analysis of feasibility by PSE in the treatment of secondary hypersplenism in liver cirrhosis

目的评估分析应用部分脾动脉栓塞术(PSE)治疗肝硬化继发脾功能亢进的可行性。方法 49例肝硬化继发脾功能亢进患者接受PSE治疗,比较患者治疗前后白细胞、血小板水平、脾脏厚径以及门静脉内径。结果所有患者均顺利完成治疗,术后白细胞、血小板水平较治疗前明显提升,差异具有统计学意义(P<0.05);术后脾脏厚径以及门静脉内径较治疗前明显缩小,差异具有统计学意义(P<0.05)。术后48 h内,发热患者49例(100.0%),腹痛患者49例(100.0%),恶心呕吐40例(81.6%),并发肺炎1例(2.0%),并发脾脏脓肿1例(2.0%),并发腹膜炎1例(2.0%),所有症状经对症治疗均好转。结论应用PSE治疗肝硬化继发脾功能亢进效果显著,安全可行,有助于减轻脾功能亢进以及门静脉压力,提高血小板、白细胞水平,可在临床治疗中推广应用。

Objective To evaluate and analyze feasibility by partial spleen artery embolism（PSE） in the treatment of secondary hypersplenism in liver cirrhosis. Methods A total of 49 patients with secondary hypersplenism in liver cirrhosis received PSE for treatment. Comparison was made on white blood cell, blood platelet levels, spleen thickness and portal vein inner diameter before and after treatment. Results All patients received successful operation, and their postoperative white blood cell and blood platelet levels were better than those before treatment. Their difference had statistical significance（P〈0.05）. The patients had obviously less spleen thickness and portal vein inner diameter after operation than those before operation, and the difference had statistical significance（P〈0.05）. In 48 h after operation, there were 49 fever cases（100.0%）, 49 stomachache cases（100.0%）, 40 nausea and vomiting cases（81.6%）, 1 case with complicated pneumonia（2.0%）, 1 case with complicated splenic abscess（2.0%）, and 1 case with complicated peritonitis（2.0%）. After symptomatic treatment, all symptoms were relieved. Conclusion Implement of PSE shows excellent effect in treating secondary hypersplenism in liver cirrhosis. This method is safe and feasible. It is helpful to reduce hypersplenism and portal vein pressure, and improve blood platelet and white blood cell levels. It is worth promotion and application in clinical treatment.