Embosphere微球及明胶海绵颗粒在脾栓塞术中的疗效及安全性分析

Efficacy and safety of partial splenic embolization with embosphere microsphere and gelfoam particles in the treatment of hypersplenism

目的比较使用Embosphere微球和明胶海绵颗粒行部分脾栓塞术(partial splenic embolization,PSE)治疗脾功能亢进(简称脾亢)的疗效和不良反应。方法 69例脾亢患者分为微球组(n=36)和明胶海绵组(n=33),分别进行PSE,比较术后14 d、1个月、3个月、6个月、1a、2 a的血常规变化及术后不良反应。结果在术后上述不同时间随访,微球组患者血小板、白细胞高于明胶海绵组(P<0.01或0.05)。两组术后栓塞综合症发生率的差异无统计学意义(P>0.05),而明胶海绵组的疼痛发生率高于微球组(84.8%vs 63.9%,P<0.05)。结论 Embosphere微球用于PSE,可快速升高白细胞、血小板,维持时间较长,术后不良反应轻微,优于明胶海绵颗粒。

Objective To compare the efficacy and adverse reactions of partial splenic embolization（PSE） with embosphere microsphere and gelfoam particles in the treatment of hypersplenism. Methods 69 patients with hypersplenism were enrolled and randomly divided into 2 groups： Microsphere Group（n=36） and Gelfoam Group（n=33）. PSE was performed for the two groups, respectively. The changes in blood routine and postoperative adverse reactions 14 d, 1 month, 3 months, 6 months, 1a and 3a after operation were compared. Results For postoperative follow-up in different time, the postPSE improvement of leukocyte and platelet counts of Microsphere Group was mostly higher than that of Gelfoam Group（P〈0.01 or 0.05）. There was no statistical difference in the incidence of post-PSE embolism syndrome between the two groups. But the incidence of abdominal pain of Gelfoam Group was higher（84.8% vs 63.9%, P〉0.05）. Conclusion The application of embosphere microsphere in PSE can achieve better efficacy in alleviating hypersplenism and has fewer complications, which is superior to gelfoam particles.