部分脾动脉栓塞术在肝硬化合并血小板减少症患者脾功能亢进治疗中的作用
Role of partial splenic arterial embolization for hypersplenism in patients with liver cirrhosis and thrombocytopenia.
作者信息
Abdella Heba M, Abd-El-Moez Amal T, Abu El-Maaty Mohammed E, Helmy Ali Z
机构信息
Department of Tropical Medicine, Ain Shams University, Cairo, Egypt.
出版信息
Indian J Gastroenterol. 2010 Mar;29(2):59-61. doi: 10.1007/s12664-010-0013-4. Epub 2010 May 5.
BACKGROUND
Hypersplenism is traditionally treated by surgical splenectomy. Transcatheter ablation of splenic parenchyma is an alternative treatment modality.
METHODS
We evaluated the efficacy and safety of partial splenic arterial embolization in 10 patients with chronic liver disease and hypersplenism with thrombocytopenia (platelet count <80,000/microL).
RESULTS
At six months follow up, median (range) platelet counts (134.5 [71.5-164] x 10(3)/microL) were significantly higher than those before treatment (33.5 [23-39] x 10(3)/microL; p<0.05]). All patients developed post-embolization syndrome. Left-sided pleural effusion and increase in amount or new development of ascites occurred in six and five patients, respectively.
CONCLUSIONS
Our data suggest that partial splenic arterial embolization leads to an increase in platelet count in patients with thrombocytopenia due to chronic liver disease and hypersplenism. However, it is often associated with complications.
背景
传统上，脾功能亢进通过外科脾切除术治疗。经导管脾实质消融是一种替代治疗方式。
方法
我们评估了10例慢性肝病合并脾功能亢进伴血小板减少（血小板计数<80,000/微升）患者行部分脾动脉栓塞术的疗效和安全性。
结果
在6个月的随访中，血小板计数中位数（范围）（134.5 [71.5 - 164]×10³/微升）显著高于治疗前（33.5 [23 - 39]×10³/微升；p<0.05）。所有患者均出现栓塞后综合征。分别有6例和5例患者出现左侧胸腔积液以及腹水量增加或新发腹水。
结论
我们的数据表明，部分脾动脉栓塞术可使慢性肝病合并脾功能亢进所致血小板减少患者的血小板计数增加。然而，它常伴有并发症。
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