Chikamori Fumio, Kuniyoshi Nobutoshi, Kawashima Takahiko, Takase Yasuhiro
Department of Surgery, Kuniyoshi Hospital, 1-3-4 Kamimachi, Kochi 780-0901, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1847-9.
BACKGROUND/AIMS: The purpose of this study was to investigate the short-term effects of partial splenic embolization (PSE) for hypersplenism on portal hemodynamics and liver function.
Thirty-seven patients with hypersplenism were included in this study.
The wedged hepatic venous pressure before and after PSE were 39 +/- 10 and 33 +/- 8 cmH2O, respectively, showing significant change (p < 0.01). The flow volumes of the splenic vein before and after PSE were 477 +/- 200 and 319 +/-187 mL/min, respectively, also showing significant change (p < 0.05). However, the flow volumes of the portal vein before and after PSE were 713 +/- 284 and 684 +/- 152 mL/min, respectively, showing no significant change. The blood laboratory parameters showed no significant change after PSE. PSE damaged neither the portal blood flow volume nor the liver function, although it improved the local hyperdynamic state in the splenic area and thrombocytopenia.
In conclusion, PSE is a safe and effective treatment for hypersplenism from the portal hemodynamic point of view.
背景/目的:本研究旨在探讨部分脾栓塞术(PSE)治疗脾功能亢进对门静脉血流动力学及肝功能的短期影响。
本研究纳入了37例脾功能亢进患者。
PSE术前、后门静脉楔压分别为39±10cmH₂O和33±8cmH₂O,差异有统计学意义(p<0.01)。PSE术前、后脾静脉血流量分别为477±200ml/min和319±187ml/min,差异有统计学意义(p<0.05)。然而,PSE术前、后门静脉血流量分别为713±284ml/min和684±152ml/min,差异无统计学意义。血液实验室参数在PSE术后无显著变化。PSE虽改善了脾区局部高动力状态及血小板减少症,但未损害门静脉血流量及肝功能。
总之,从门静脉血流动力学角度来看,PSE是一种治疗脾功能亢进的安全有效的方法。