联合脾动脉栓塞术治疗外科术中高出血风险的胰源性门脉高压——前瞻性非随机对照研究

Splenic artery embolization in the treatment of pancreatic sinistral portal hypertension with high risk of bleeding during surgery:A prospective non-randomized study

目的:采用前瞻性非随机对照方法,研究联合介入下脾动脉栓塞术在外科治疗术中高出血风险的胰源性门脉高压患者过程中的应用价值。方法:纳入60例胰源性门脉高压患者,按照术前评估结果,分为术中高出血风险组(n=18)和低风险组(n=42),高风险组患者术前先行介入脾动脉栓塞术,术后24 h内行脾切除术;低风险组直接行脾切除术,对比二者术中术后相关指标的差异。结果:与低风险组相比,高风险组手术时间缩短,术中出血量减少,差异有统计学意义(P<0.05),术后并发症发生率等指标差异无统计学意义。结论:联合介入脾动脉栓塞术的外科手术在治疗术中高出血风险的胰源性门脉高压患者时能够使患者获益。

Objective: To analyze the value of splenic artery embolization in the treatment of pancreatic sinistral portal hypertension with high risk of bleeding during surgery, through a prospective non-randomized study. Methods: Sixty patients with pancreatic sinistral portal hypertension were included,They were divided into two groups according to preoperative assessment results: high-risk group(n=18) and low-risk group(n=42). Patients in the high-risk group underwent splenic artery embolization 24 hours before splenectomy, and patients in the low-risk group underwent direct splenectomy.Comparethedifferences of intraoperative and postoperative outcomes between two groups. Results: Compared with the low-risk group, the high-risk group had shorter operation time and reduced intraoperative blood loss. The differences was statistically significant(P<0.05). There was no significant difference in postoperative complication rate and other indexes between the two groups.Conclusion: Surgery combined with splenic artery embolization may benefit patients with pancreatic sinistral portal hypertension who are at high risk for intraoperative bleeding.