肝脾动脉栓塞术治疗肝癌伴门脉高压及脾亢

HEPATO-SPLENIC ARTERIAL EMBOLIZATION FOR TREATMENT OF LIVER CANCER WITH PORTALHYPERTENSION AND HYPERSPLENISM

目的:探讨肝脾动脉栓塞术治疗肝癌伴门脉高压及脾亢的价值。材料与方法:160例患者白细胞、血小板平均值分别为2.7x10^9/L、55.6×10~9/L,121例(75.6%)食道胃底静脉曲张,全部患者在肝动脉化疗栓塞术的同时行部分脾栓塞术(PSE),其中52例行2次以上 PSE。结果:86.3%(138/160)患者术后白细胞及血小板恢复正常,2个月复查白细胞、血小板平均值分别为6.5×10~9/L、166.8×10~9/L,6个月复查为4.7×10~9/L、114.2×10~9/L,较术前明显增高,门脉高压症状减轻,肝功能改善,78.8%(126/160)病人肿瘤得到控制,75.0%(120/160)病人 AFP下降,1、2、3年生存率分别为68.1%、38.2%、20.6%。结论:肝脾动脉栓塞术治疗肝癌伴门脉高压、脾亢是一种安全有效的方法。

Objective:To evaluate the usefulness of hepato-splenic arterial embollzation for treatment of liver can-cer with portalhypertension and hypersplenism.Materials and Methods:The average white blood cell and thrombocyte counts were 2.7×10~9/L and 55.6×10~9/L respectively in 160 patleflts.Among these cases,121 cases(75.6%)suffered from esophagogastric vein varication.All patients received hepatic arterial chemoinfusion(HAI)and/or chemoembolization(HAE)with partial spleen embolization(PSE),within 52 patients received PSE twice or more.Results:The postoperative examination of white blood cell and thrombocyte counts were more than preoperative,the counts were return to normal in 86.3%(138/160)after received the first PSE.The examination of the average white blood cell and thrombocyte counts achieved 6.5×10~9/L and 166.8×10~9/L respectively,2 months after the operation,and with the counts of 4.7×10~9/L and 114.2×10~9/L 6 months after the operation.The symptoms of portalhypertension were some relief and the hepatic functions were improved.The tumor diminished in 126 cases(78.8%)and 120 cases(75.0%)with AFP decreased after operation.The survival rate were 68.1%,38.2%,20.6% respectively in follow-up for 1,2,3 year.Conclusions:The hepato-splenic arterial embolization is a safe and effective therapeutic method for treatment of liver cancer with portalhy-pertension and hypersplenism.