Li Liang-Yong, Chen Huai-Zhen, Bao Yuan-Cheng, Yu Qing-Sheng, Yang Wen-Ming
a Department of Neurology , the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine , Hefei , China.
b Department of General Surgery , the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine , Hefei , China.
J Invest Surg. 2018 Apr;31(2):75-81. doi: 10.1080/08941939.2016.1278058. Epub 2017 Jan 31.
Hypersplenism can occur in patients with Wilson's disease (WD). Surgical splenectomy is a conventional treatment for this condition; however, emotional and neurological deterioration may follow splenectomy. In recent years, partial splenic embolization (PSE) has been increasingly performed as a nonsurgical alternative treatment for hypersplenism. The aim of this study was to evaluate the effectiveness and safety of PSE compared with splenectomy in the treatment of hypersplenism in WD patients.
Fifty WD patients with hypersplenism were randomly divided into two groups (group A and group B), each including 25 patients. Patients in groups A and B were treated with PSE and splenectomy, respectively. Data were collected on the clinical efficacy of each procedure, adverse reactions, hematologic and blood chemistry test results, and abdominal computed tomography (CT) scan findings (group A only).
Marked improvements in the platelet and leukocyte counts after PSE and splenectomy were observed in all patients. PSE was associated with improved liver function without severe complications, and no significant changes in emotional and neurological symptoms were observed. In contrast, seven WD patients suffered neurological deterioration after splenectomy.
Hypersplenism in WD patients was successfully treated by PSE, which appears to be a safe and effective alternative treatment for WD-induced hypersplenism.
肝豆状核变性(WD)患者可出现脾功能亢进。外科脾切除术是治疗这种情况的传统方法;然而,脾切除术后可能会出现情绪和神经功能恶化。近年来,部分脾栓塞术(PSE)作为脾功能亢进的非手术替代治疗方法越来越多地被采用。本研究的目的是评估PSE与脾切除术相比在治疗WD患者脾功能亢进中的有效性和安全性。
50例WD合并脾功能亢进患者随机分为两组(A组和B组),每组25例。A组和B组患者分别接受PSE和脾切除术治疗。收集了每种手术的临床疗效、不良反应、血液学和血液化学检测结果以及腹部计算机断层扫描(CT)扫描结果(仅A组)的数据。
所有患者在接受PSE和脾切除术后血小板和白细胞计数均有明显改善。PSE可改善肝功能且无严重并发症,情绪和神经症状无明显变化。相比之下,7例WD患者在脾切除术后出现神经功能恶化。
PSE成功治疗了WD患者的脾功能亢进,似乎是WD所致脾功能亢进的一种安全有效的替代治疗方法。