Harao Michiko, Beppu Toru, Masuda Toshiro, Hayashi Hiromitsu, Okabe Hirohisa, Okabe Kazutoshi, Imseung Choi, Komori Hiroyuki, Horino Kei, Baba Hideo
Dept. of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University.
Gan To Kagaku Ryoho. 2008 Nov;35(12):2027-9.
Partial splenic embolization (PSE) is often performed to improve thrombocytopenia in liver cirrhotic patients. The aim of this study was to evaluate the efficacy and safety of PSE in combination with trans-catheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
From January 2004 to December 2007, 8 HCC patients associated with hypersplenism caused by cirrhosis were synchronously treated with TACE and PSE. Fifteen patients with TACE alone at the same period were enrolled as a control. Follow-up examinations included a calculation of peripheral blood cells (leukocytes and platelets), liver damage, duration until recovery, and treatment-associated complications.
Initially, there were no significant differences in sex, age, Child-Pugh grade and peripheral blood cell counts between two groups. After treatment, leukocyte and platelet counts were significantly higher in PSE combined with TACE group during the follow-up period than TACE group (p<0.01). Severe complications never occurred in both groups.
PSE combined with TACE is more effective than TACE alone for patients with HCC associated with hypersplenism caused by cirrhosis.
部分脾栓塞术(PSE)常用于改善肝硬化患者的血小板减少症。本研究旨在评估PSE联合经导管动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)的疗效和安全性。
2004年1月至2007年12月,8例因肝硬化导致脾功能亢进的HCC患者同时接受了TACE和PSE治疗。同期15例仅接受TACE治疗的患者作为对照。随访检查包括外周血细胞(白细胞和血小板)计数、肝损伤、恢复所需时间以及治疗相关并发症。
两组患者初始时在性别、年龄、Child-Pugh分级和外周血细胞计数方面无显著差异。治疗后,随访期间PSE联合TACE组的白细胞和血小板计数显著高于TACE组(p<0.01)。两组均未发生严重并发症。
对于因肝硬化导致脾功能亢进的HCC患者,PSE联合TACE比单纯TACE更有效。