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目的探寻脾亢患者部分性脾栓塞(PSE)术较为合适的栓塞方法。方法78例脾亢患者中32例为脾动脉主干内PSE术(主干组),46例为脾动脉分干内PSE术(分干组)。所有患者术后观察并发症情况,第15d、30d、60d、90d分别复查白细胞和血小板计数,并与术前比较,以此评价PSE术的疗效。然后对主干组和分干组结果进行对比分析。结果78例患者术后均无严重并发症,脾外栓塞及呼吸系统并发症分干组较主干组轻而少。术后白细胞和血小板计数,第15天时主干组和分干组比较差异均无显著性意义(P>0.05);第30天时二者比较差异均有显著性意义(P<0.05);第60天、90天时二者比较差异则均有非常显著性意义(P<0.001)。结论对于脾亢患者,脾动脉分支若呈二干型或三干型,则应尽量行分干内PSE术;分支若呈无干型或主干明显扭曲而插管困难时,则宜行主干内PSE术。
Objective To investigate the more appropriate embolization method for partial splenic embolization (PSE) in patients with hypersplenism. Methods Thirty-two patients with hypersplenism were treated with PSE (trunk group) in the main splenic artery and 46 with PSE (split-stem group) in the splenic artery. All patients were observed postoperative complications, 15d, 30d, 60d, 90d were reviewed white blood cell count and platelet count, and compared with preoperative, in order to evaluate the efficacy of PSE. Then the backbone group and the results of dry-group comparative analysis. Results There were no serious complications after operation in 78 patients. The splenic embolization and respiratory complications were lighter and less than those in the trunk group. There was no significant difference in the number of leukocytes and platelets between the trunk group and the stem-branch group on the 15th day (P> 0.05). On the 30th day, there was significant difference between the two groups (P <0.05) At 90 days, the difference was significant (P <0.001). Conclusion For patients with hypersplenism, if the splenic artery branches are dry or dry type, PSE should be performed as far as possible. If the branch is dry or the trunk is obviously distorted and the intubation is difficult, then the PSE Surgery.