部分脾栓塞术对肝硬化脾功能亢进的介入治疗

目的:探讨和评价部分脾栓塞术(PSE)治疗肝硬化脾功能亢进的临床应用价值。方法:采用Seldinger技术对28例乙肝后肝硬化伴脾功能亢进患者用高压消毒明胶海绵颗粒共进行31次PSE。结果:28例手术中27例获得成功,栓塞范围为30％-60％,25位患者术后1周以内、1-2周及2周以上WBC和PLT均有不同程度的上升(P<0.01),临床有效率为92.6％。手术前后肝功能变化不大。全部病例均未发生严重并发症。结论:部分脾栓塞术对治疗肝硬化脾亢有明显疗效,可替代脾切除术。对肝功能的改善,近期疗效不明显。

Interventional Therapy to hypersplenism in liver cirrhosis by Partial Splenic Embolization(PSE)

Purpose: :To probe and evaluate the clinical value of Partial splenic embolization(PSE) in hyper-splenism in liver cirrhosis. Method:: 28 patients of hypersplenism in liver cirrhosis were treated with PSE by injecting grain of gelfoam disinfected to embolize partial spleen arteries. In three patients we carried out PSE twice. Results: The procedures of PSE were successful in 27 cases. The extent of PSE was controlled within 30% - 60%. The average counts of WBC and PLT were significantly increased at < Iw, Iw- 2w and >w after PSE (P< 0.01) in 25 cases(92.6%). There were no significant changes of hepatic function between before and after PSE. No severe complications occurred in all cases. Conclusions:: PSE is a safe and effective therapy to hypersplenism in liver cirrhosis, and it can take the place of splenectomy. PSE shows no infection to hepatic function in recent period.