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[射频消融治疗门静脉高压症所致脾功能亢进的临床研究]

[Radiofrequency ablation for hypersplenism due to portal hypertension: clinical study].

作者信息

Liu Quan-da, Ma Kuan-sheng, He Zhen-ping, Wu Qiao, Zhou Ning-xin, Dong Jia-hong

机构信息

Institute of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 Apr 20;85(15):1031-4.

Abstract

OBJECTIVE

To investigate the feasibility, efficacy and clinical prospects of radiofrequency ablation (RFA) for hypersplenism in patients with liver cirrhosis and portal hypertension.

METHODS

The laboratory and radiologic data over one-year period of patients undergone splenic RFA were analyzed.

RESULTS

Nine patients undergone splenic RFA has closely followed-up over 1 year. During hospitalization, no procedure-related complications occurred, only minor complications including hydrothorax (3/9 patients) and mild abdominal pain (4/9 patients) were observed. After treatment, average 30.7% (20%-43%) of spleen volume was ablated, and the platelet count reached peak on 14th post-procedure day. White blood cell and platelet counts, liver function, and hepatic artery blood flow had gained significant improvements comparing with those before RFA procedures. Hyperplasia/regeneration was also occurred in cirrhotic liver after splenic RFA.

CONCLUSION

Radiofrequency ablation is a safe, effective and minimally invasive approach for the management of hypersplenism in patients with liver cirrhosis and portal hypertension. Increased hepatic artery blood flow can contribute to significant improvement of liver function, and maybe potentially stimulate liver regeneration in cirrhotic liver.

摘要

目的

探讨射频消融术(RFA)治疗肝硬化门静脉高压症脾功能亢进的可行性、疗效及临床前景。

方法

分析接受脾脏RFA治疗患者一年期间的实验室及影像学资料。

结果

9例接受脾脏RFA治疗的患者接受了超过1年的密切随访。住院期间,未发生与手术相关的并发症,仅观察到少量并发症,包括胸腔积液(3/9例患者)和轻度腹痛(4/9例患者)。治疗后,脾脏平均消融体积为30.7%(20%-43%),血小板计数在术后第14天达到峰值。与RFA手术前相比,白细胞和血小板计数、肝功能及肝动脉血流均有显著改善。脾脏RFA术后肝硬化肝脏也出现增生/再生。

结论

射频消融术是治疗肝硬化门静脉高压症脾功能亢进的一种安全、有效且微创的方法。肝动脉血流增加有助于肝功能显著改善,且可能潜在地刺激肝硬化肝脏的再生。

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