部分脾栓塞治疗肝硬化脾亢的临床研究

Clinical study on partial splenic embolization for the treatment of hypersplenism in liver cirrhosis

目的 评估部分脾栓塞治疗肝硬化脾亢的临床疗效及价值。方法 1 988年 6月至 2 0 0 2年 1 2月期间对 1 0 6例肝硬化脾亢患者实施了部分脾栓塞术 ,观察治疗前后血常规、肝肾和凝血功能 ,B超及彩色 Doppler超声检查明确肝脾大小和门脉系统血流情况 ,并严密观察病情变化 ,注意防治并发症。结果 本组 1 0 6例手术均成功 (1 0 0 % ) ,术后随访 6～ 1 2个月 ,其血红蛋白含量、白细胞和血小板计数均值较术前显著增加 (P<0 .0 1 )并恢复正常 ,同时其门脉直径、脾血流量和血白蛋白含量均值较术前改善 (P<0 .0 1 )。结论 部分脾栓塞是治疗肝硬化脾亢的一种疗效较好 。

Objective To assess the therapeutic effects and value of PSE on the treatment of hypersplenism in liver cirrhosis. Methods 106 patients were diagnosed as hypersplenism of liver cirrhosis in our departmant from June 1988 to December 2002 and treated by PSE. Compared pretreatment and posttreatment,blood route and biochemical analysis were observed. The size of liver and spleen was determined by B ultrasound, and the amount of blood flow from portal vein was confirmed by colour Doppler ultrasound. Be care of the patients clinical manifestation alterating and pay attention to any complication. Results The successful rate of PSE was 100%. Follow up the patients for 6～12 months in this study. Hemoglobin, white blood cell and platelet count increased obviously up to normal level after PSE( P <0.01);the mean size of diameter of portal vein and splenic blood flow volume decreased, and the serum alblumin increased after treatment ( P <0.01) . Conclusions PSE should be recommended as an effective means of treating hypersplenism of liver cirrhosis.