Duan Ya-Qi, Liang Ping
Department of Ultrasound, General Hospital of Beijing Military Command, Beijing, China.
Hepatogastroenterology. 2013 May;60(123):501-6. doi: 10.5754/hge12853.
Many studies have been conducted on splenic thermal ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In this article, we review the evolution and current status of radiofrequency and microwave ablation in the treatment of spleen diseases. All publications from 1990 to 2011 on radiofrequency and microwave ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism were retrieved by searching PubMed. Thermal ablation in the spleen for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism can preserve part of the spleen and maintain splenic immunologic function. Thermal ablation for assisting hemostasis in partial splenectomy minimizes blood loss during operation. Thermal ablation for spleen trauma reduces the number of splenectomy and the amount of blood transfusion. Thermal ablation for splenic metastasis is minimally invasive and can be done under the guidance of an ultrasound, which helps shorten the recovery time. Thermal ablation for hypersplenism increases platelet (PLT) and white blood cell (WBC) counts and improves liver function. It also helps to maintain splenic immunologic function and even improves splenic immunologic function in the short-term. In conclusion, thermal ablative approaches are promising for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In order to improve therapeutic effects, directions for future studies may include standardized therapeutic indications, prolonged observation periods and enlarged sample sizes.
关于脾热消融用于部分脾切除止血、脾外伤、脾转移和脾功能亢进的研究已有很多。在本文中,我们回顾了射频和微波消融在脾脏疾病治疗中的发展历程和现状。通过检索PubMed数据库,获取了1990年至2011年间所有关于射频和微波消融用于部分脾切除止血、脾外伤、脾转移和脾功能亢进的文献。脾热消融用于部分脾切除止血、脾外伤、脾转移和脾功能亢进可保留部分脾脏并维持脾脏免疫功能。部分脾切除术中热消融辅助止血可减少术中失血。脾外伤热消融可减少脾切除数量和输血量。脾转移热消融微创,可在超声引导下进行,有助于缩短恢复时间。脾功能亢进热消融可增加血小板(PLT)和白细胞(WBC)计数并改善肝功能。它还有助于维持脾脏免疫功能,甚至在短期内改善脾脏免疫功能。总之,热消融方法在部分脾切除止血、脾外伤、脾转移和脾功能亢进方面具有广阔前景。为提高治疗效果,未来研究方向可能包括标准化治疗指征、延长观察期和扩大样本量。