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目的 探讨肝硬化门脉高压引起脾功能亢进的介入栓塞治疗效果。方法 采用Seldinger法穿刺股动脉 ,选择或超选择插管进入脾动脉和 /或其分支血管 ,行部分性栓塞共 2 6例 ,术前血小板、白细胞计数均明显低于正常水平。结果 脾动脉栓塞后 3～ 5d血小板、白细胞显著增加 ,1～ 2周升至或超过正常范围。术后 2月血小板、白细胞计数明显高于术前 ,具有极显著性意义 (Ρ <0 .0 1)。 2 6例患者术后均有脾区疼痛 ,2 4例有发热 ,随访时间 1～ 44月 ,平均 15 .7个月 ,除 2例死于肝癌外其他病例均存活 ,2例血小板计数低于正常 ,但高于术前水平。结论 脾动脉部分栓塞属微创手术 ,既能保留脾脏的免疫功能 ,又能有效地缓解脾功能亢进和门脉高压 ,对肝硬化脾功能亢进的患者是一条安全、有效的治疗途径
Objective To investigate the therapeutic effect of interventional embolization in patients with cirrhosis and portal hypertension caused by hypersplenism. Methods The Seldinger method was used to puncture the femoral artery. The catheter was selected or superselective intubated into the splenic artery and / or its branch vessels. A total of 26 cases underwent partial embolization. Preoperative platelet and leukocyte counts were significantly lower than normal. Results After 3 ~ 5 days of splenic artery embolization, the number of platelets and white blood cells increased significantly and reached or exceeded the normal range in 1 ~ 2 weeks. The platelet and white blood cell count in February after operation were significantly higher than those before operation (P <0.01). Twenty-six patients had pain in the spleen area after operation, 24 patients had fever, and the follow-up time ranged from 1 to 44 months (mean 15.7 months). All the other 2 patients died except liver cancer, and 2 patients had lower platelet count Normal, but above preoperative levels. Conclusions Partial embolization of the splenic artery is a minimally invasive operation, which not only retains immune function of the spleen, but also effectively relieves hypersplenism and portal hypertension and is a safe and effective treatment for patients with cirrhosis and hypersplenism