摘要
目的:观察经皮穿刺部分性脾栓塞术(PSE)治疗肝硬化脾功能亢进患者的临床疗效。方法:28例经B超、CT和临床资料证实为肝硬化脾功能亢进患者。采用Seldinger技术,将4～5FRH导管经右侧股动脉插至脾动脉,行DSA检查,观察脾动脉的分支及结构和脾脏大小,对栓塞范围进行评估,然后超选择插管脾动脉远端近脾门处,经导管注入用抗生素浸泡的1mm×1mm×1mm大小的明胶海绵颗粒行部分栓塞术。结果:脾动脉插管技术成功率为100%。术后2周、3个月复查外周血白细胞和血小板,其中26例外周血白细胞和血小板计数恢复到正常水平,2例部分缓解;所有患者术后均出现栓塞后综合征,主要表现为发热和左上腹疼痛,无脾脓肿等严重并发症发生。结论:PSE对脾亢患者是一种微创、安全、有效的治疗方法。既可减轻脾亢又保留了脾脏的免疫功能,且并发症少、恢复快。外周血白细胞、血小板计数可作为评价脾部分栓塞术后疗效的可靠指标。
Objective：To perform the clinical analysis in the treatment of liver cirrhosis hypersplenism by percutaneous partial splenic encbolism.Methods：28 cases of hypersplenism comfirmed by B ultrasonic, CT and clinical data, were inserted the 5F RH catheter by the technology of Seldinger through the right femoral artery into the splenic artery,performed DSA to display the dimension of spleen and the structure,subdivision of splenic artery and evaluate the area of enbolism and then,super-selectedly inserted the catheter splenic artery stem and sequentially into the dital of splenic artery near the hilum of spleen.The partial splenic embotization was performed with 1mm×1mm×1mm gelfoara particles soaked by antibiotic.Results：The rate of success of the splenic embolization technique was 100%. Peripheral blood leucocyte and platelet count were up to normal in 26 cases.2 cases had partial remission. All the patients appeared partial embolization syndrome such as fever and abdominal pain on left upper abdomen.No severe complications occurred as spleen abscess etc. Conclusion：PSE is a safe and effective treatment technique which not only reduces hypersplenism but also reserves the splenic immunity.The quantity and function change of leucocyte and platelet is reliable observation index after PSE. PSE has the speciality of reserve spleen function, and the advantages of safety, minute trauma ,few complication and quick recovery.
出处
《现代医药卫生》
2008年第2期174-175,共2页
Journal of Modern Medicine & Health
关键词
脾功能亢进
部分脾动脉栓塞
肝硬化
Hypersplenism
Partial splenic embolization
Liver cirrhosis
