部分脾动脉栓塞术治疗脾功能亢进症32例疗效观察

摘要

目的 探讨部分脾动脉栓塞术(PSE)治疗脾功能亢进症的疗效及临床意义.方法 对31例肝硬化合并脾功能亢进(脾亢)患者、1例地中海贫血患者行PSE,观察术前和术后的血象变化、脾脏大小及并发症情况.结果 32例患者术后白细胞和血小板明显上升,地中海贫血患者术后红细胞上升明显,脾脏2～3 个月后缩小,1年后12例回访,其中3例脾脏代偿性增生,脾亢复发,血象再次下降.术后1例肝硬化患者因重度食道静脉曲张破裂出血死亡.结论 PSE治疗脾功能亢进症疗效确切,但应重视脾亢复发和术后并发症.%Objective To assess the therapeutic effect and clinical significance of partial splenic artery embolization(PSE) in the treatment of hypersplenism. Methods 31 cases with liver cirrhosis accompanied by hypersplenism, 1 case with thalassemia was treated with PSE. the preoperative and postoperative variations of hemogram, spleen size and postoperative complications were observed. Results After PSE,the numbers of white blood cells(WBC)and peripheral blood platelets(PLT) counts of all of the patients rasied obviously compared with preoperation. The red blood cells(RBC) amount of case with thalassemia increased obviously,the splenic thick became thinner after 2- 3 months. In the return check for 12 cases after one year, 3 cases of them recured,and their hemogram descended again. 1 case with liver cirrhosis died for sever esophageal varices which leaded to upper gastrointestinal hemorrhage. Conclusion PSE has significant efficacy on hypersplenism, However, the complications and the recrudescence of hy persplenism should be cared.