肝癌患者合并脾功能亢进的介入治疗

Interventional therapy on primary hepatic cancer with portal hypertension and hypersplenism

目的评价联合应用肝动脉栓塞灌注化疗和部分性脾栓塞治疗肝癌患者脾功能亢进的临床价值。方法收集原发性肝癌合并门脉高压患者85例,经导管行肝动脉栓塞灌注化疗同时行部分性脾栓塞,术前患者周围血细胞计数均低,以白细胞、血小板降低为显著。结果肝动脉,脾动脉分别插管成功率100.0%。术后24h外周血白细胞,血小板计数开始升高(P<0.01)。1月后,65例(76.4%)达正常水平,18例(21.2%)部分缓解,2例(2.4%)无效,术后食欲、体能及胃底静脉曲张均有所改善,无严重并发症发生。结论对于肝癌并脾功能亢进患者,在行肝动脉栓塞灌注化疗同时行部分性脾栓塞术,安全可靠,既能有效控制肿瘤发展,又能有效改善血象,提高机体免疫力和生活质量。

Objective:To evalute the clinical efficiency of partial splenic embolization and transcatheter arterial chemoembolization on portal hypertenison patients of hepatocellulocarcinoma(HCC).Methods:85pa-tients of hepatocellulocarcinoma with portohypertension were treated by transcatheter arterial chemoembolization and partial splenic embolization.All patients had low peripheral blood count,especially low leukocyte and platelet before the operation.Results:The rate of success with the transcatheter arterial chemoembolization and partial splenic embolization technique were100%.Peripheral blood leukocyte and platelet counts were in-creased after the24hour(P<0.01)and the counts in65cases(76.4%)were up to normal,18cases(21.2%)were partially recovered,2cases(2.4%)didn't change after one month.The improvements on appetite,vigor and remission of varix were fruitful and no severe complication happened.Conclusions:Transcatheter arterial chemoembolization and partial splenic embolization are safe and effective treatment techniques in HCC patients with portohypertension,they have the effect controlling development of HCC,increasing blood cell counts,ele-vating immunity and improving living quality.