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目的应用部分性脾动脉栓塞(PSE)治疗儿童遗传性球形红细胞增多症(HS)。材料与方法 PSE 治疗 HS22例,男14例,女8例,年龄5个月～8岁之间。本组病例在外周血中可见20%～60%不等比例小球样变形红细胞。临床特点为慢性经过伴急性发作性溶血性贫血。PSE 治疗中采用5～6F 脾管或眼睛蛇导管,应用Seldinger 技术将导管插入脾动脉,取1.5mm×1.5mm×2mm 海绵颗粒行脾段动脉栓塞,栓塞面积在50%～70%。结果 PSE 术后短时期内全部病例溶血性贫血症状明显改善,血红蛋白、红细胞、血小板等项指标迅速恢复到正常水平。免疫功能测定各项指标保持正常,经 PSE 治疗1～5年后随访疗效稳定。结论 PSE 通过有效的缩小血细胞破坏场所,达到控制和改善 HS 溶血性贫血。
Objective To treat children with hereditary spherocytosis (HS) by partial splenic arterial embolization (PSE). Materials and Methods PSE treatment of HS22 cases, 14 males and 8 females, aged 5 months to 8 years old. This group of patients in the peripheral blood can be seen in 20% to 60% ranging from small ball-like deformation of red blood cells. Clinical features are chronic with acute episodic hemolytic anemia. PSE treatment using 5 ~ 6F splenic or snake catheter, the use of Seldinger catheterization of the splenic artery, 1.5mm × 1.5mm × 2mm sponge particles splenic artery embolization, embolization area of 50% to 70%. Results The symptoms of hemolytic anemia in all the cases were significantly improved in short period after PSE, and the indexes such as hemoglobin, red blood cells and platelets returned to normal quickly. Immune function determination of various indicators remain normal, after 1 to 5 years of PSE treatment follow-up efficacy and stability. Conclusions PSE can effectively control and improve HS hemolytic anemia by effectively reducing the blood cell destruction sites.