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目的探讨部分性脾栓塞术(PSE)治疗肝硬化伴门静脉高压及脾功能亢进症的意义和疗效。方法应用介入治疗的手段,经股动脉插管向脾动脉注射栓子进行栓塞术,治疗肝硬化并发门脉高压及脾功能亢进症33例,观察术前术后外周血细胞、肝功能的变化、门静脉宽度、脾脏大小、腹水消退及并发症发生情况。结果(1)术后外周血象较术前明显改善。(2)术后肝功能明显好转。(3)远期(6~9月后)门脉宽度缩小。(4)术后近期(1~3个月)脾脏大小变化不明显,6~9个月后明显缩小。(5)25例有腹水者,腹水消失20例,腹水减少5例。(6)术后并发症:均有腹痛、发热,部分出现左侧少量胸水(13例)、左下肺炎(10例)。结论PSE是肝硬化门脉高压、脾功能亢进安全有效新的治疗方法。
Objective To investigate the significance and efficacy of partial splenic embolization (PSE) in the treatment of liver cirrhosis with portal hypertension and hypersplenism. Methods Thirty-three cases of cirrhosis complicated with portal hypertension and hypersplenism were treated by means of interventional therapy through cannulation of the femoral artery with embolism. The changes of peripheral blood cells and liver function were observed before and after operation. Portal vein width, spleen size, ascites regression and complications. Results (1) Postoperative peripheral blood as significantly improved compared with preoperative. (2) postoperative liver function improved significantly. (3) long-term (6 to 9 months) reduced portal width. (4) The size of the spleen did not change obviously in the short term (1-3 months) after operation, but obviously decreased after 6 ~ 9 months. (5) 25 cases of ascites, ascites disappeared in 20 cases, ascites decreased in 5 cases. (6) postoperative complications: abdominal pain, fever, some left pleural effusion (13 cases), left lower pneumonia (10 cases). Conclusions PSE is a safe and effective new treatment for hepatic cirrhosis with portal hypertension and hypersplenism.