分次部分脾动脉栓塞治疗青少年脾功能亢进

Interval-spaced Sessions of Partial Splenic Artery Embolization in Juvenile Patients with Hypersplenism

目的研究分次部分脾动脉栓塞(PSE)治疗青少年脾功能亢进的安全性和有效性。方法回顾性分析8例(男性3例、女性5例)青少年脾功能亢进患者进行分期PSE治疗的效果,患者经2~3次的PSE手术治疗,每次间隔1~2个月。术后长期随访。结果无术后死亡;无感染性休克、脾脓肿或脾破裂等并发症;术后均出现疼痛与发热,经对症治疗后缓解;2例术后出现少量局灶性胸腔积液,经保守治疗后缓解。所有患者术后血小板、白细胞数量均明显增加,并在随访中维持在正常范围内。结论应用分次PSE手术方式治疗青少年脾功能亢进,可有效缩小增大的脾脏,缓解脾功能亢进症,并避免患者因一次性栓塞脾组织过多而出现的相关并发症。

Objective To determine whether interval-spaced sessions of partial splenic artery embolization(PSE)is a safe and effective alternative treatment for hypersplenism in juvenile patients.Methods Eight patients(3 males and 5 females)were included in this retrospective study.All patients were diagnosed as hypersplenism and underwent PSE in 2-3 sessions separated by 1-2 month intervals.Immediate,short,and long term follow-up were done.The effectiveness of the treatment was evaluated.Results No major postoperative complication was noted.No patient developed septic shock,splenic abscess,or spleen rupture.Postoperative pain and fever were common and manageable;only two patients developed loculated pleural effusions,which were well alleviated after conservative treatment.All patients showed significant increase in thrombocytes and white blood cells count after the first session of embolization.The cell counts became remarkable after the last session and remained at normal levels during the follow-up period.Conclusions PSE using 2-3 interval-spaced sessions can effectively decrease spleen size and reverse hypersplenism in juvenile patients.Also,it may reduce the postoperative complications commonly seen in traditional PSE.