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目的评估分析应用部分脾动脉栓塞术(PSE)治疗肝硬化继发脾功能亢进的可行性。方法 49例肝硬化继发脾功能亢进患者接受PSE治疗,比较患者治疗前后白细胞、血小板水平、脾脏厚径以及门静脉内径。结果所有患者均顺利完成治疗,术后白细胞、血小板水平较治疗前明显提升,差异具有统计学意义(P<0.05);术后脾脏厚径以及门静脉内径较治疗前明显缩小,差异具有统计学意义(P<0.05)。术后48 h内,发热患者49例(100.0%),腹痛患者49例(100.0%),恶心呕吐40例(81.6%),并发肺炎1例(2.0%),并发脾脏脓肿1例(2.0%),并发腹膜炎1例(2.0%),所有症状经对症治疗均好转。结论应用PSE治疗肝硬化继发脾功能亢进效果显著,安全可行,有助于减轻脾功能亢进以及门静脉压力,提高血小板、白细胞水平,可在临床治疗中推广应用。
Objective To evaluate the feasibility of using partial splenic arterial embolization (PSE) in the treatment of secondary hypersplenism caused by cirrhosis. Methods Forty-nine patients with liver cirrhosis and secondary hypersplenism were treated with PSE. The levels of leukocytes, platelets, the diameter of spleen and the diameter of portal vein were compared before and after treatment. Results All the patients were successfully treated. The levels of white blood cells and platelets were significantly increased after treatment compared with those before treatment (P <0.05). The diameter of the spleen and the diameter of the portal vein were significantly smaller than those before treatment, the difference was statistically significant (P <0.05). Within 48 hours after operation, 49 cases (100.0%) had fever, 49 cases (100.0%) had abdominal pain, 40 cases (81.6%) had nausea and vomiting, 1 case had pneumonia (2.0%) and 1 case had spleen abscess (2.0% ), 1 case of peritonitis (2.0%), all symptoms were improved by symptomatic treatment. Conclusion The application of PSE in the treatment of hepatic cirrhosis with secondary hypersplenism is effective and safe. It is helpful to reduce the hypersplenism and the pressure of portal vein and increase the level of platelet and leucocyte. It can be widely used in clinical treatment.