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目的:探讨肝炎后肝硬化合并脾功能亢进患者行部分脾动脉栓塞治疗后的临床效果。方法:32例肝炎后肝硬化合并脾功能亢进患者行部分脾动脉栓塞术,观察术前术后白细胞、血小板计数及脾脏大小变化,并进行比较。结果:术后白细胞、血小板计数上升,与术前比较差异有统计学意义(P<0.05)。术后脾动脉栓塞面积30%～70%。32例均有不同程度发热,体温38.0～39.5℃,持续1～4周,对症处理后缓解,出现恶心25例、呕吐10例、食欲减退7例、左下腹不适30例、左下肺炎1例、左侧胸痛1例、少量胸腔积液1例。1例肝功能Child-Pugh分级C级患者术后28d后死于肝功能衰竭。结论:部分脾动脉栓塞治疗脾功能亢进安全、有效、创伤小、并发症少。
Objective: To investigate the clinical effect of partial splenic arterial embolization in patients with posthepatitic cirrhosis and hypersplenism. Methods: Thirty-two patients with posthepatitic cirrhosis complicated with hypersplenism underwent partial splenic arterial embolization. The changes of leucocyte, platelet count and spleen size were observed and compared before and after operation. Results: The number of white blood cells and platelets increased after operation, with statistical significance (P <0.05). Postoperative splenic artery embolization area of 30% to 70%. 32 patients had different degrees of fever, body temperature 38.0 ~ 39.5 ℃ for 1 to 4 weeks, symptomatic relief after treatment, nausea in 25 cases, vomiting in 10 cases, loss of appetite in 7 cases, 30 cases of left lower quadrant discomfort, 1 case of left lower pneumonia, Left chest pain in 1 case, a small amount of pleural effusion in 1 case. One case of liver function Child-Pugh grade C patients died of liver failure after 28 days. Conclusion: Some splenic arterial embolization is safe and effective in treating hypersplenism with less trauma and fewer complications.