Zhang Lei, Zhang Zhan-Guo, Long Xin, Liu Fei-Long, Zhang Wan-Guang
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, People's Republic of China.
Risk Manag Healthc Policy. 2020 Feb 19;13:135-140. doi: 10.2147/RMHP.S234628. eCollection 2020.
Splenomegaly/hypersplenism is one of the most common complications of portal hypertension. Splenic artery embolization (SAE) has been increasingly used for treatment of splenomegaly/hypersplenism. However, few studies focused on the severe complications after embolization. In this paper, we reported 16 cases of severe complications after SAE for portal hypertension.
From February 2011 to January 2019, 16 cirrhotic patients were diagnosed with severe complications after embolization. The clinical symptoms, therapies and prognosis were analyzed.
In these patients, the splenic embolization volume was between 50% and 70%. Among 16 cases, 7 patients were diagnosed with splenic abscess and/or left subphrenic abscess, suffered from the insistent fever, and eventually underwent the surgical therapy; 6 patients with left refractory pleural effusion, suffered from severe chest distress, and underwent repeated thoracocentesis or thoracic closed drainage; 3 patients with thrombosis in portal vein needed oral warfarin therapy.
In cirrhotic patients, the severe complications after SAE are not uncommon after the procedure. It causes more suffering, prolonged hospital stay and more medical cost in these patients. It was debatable whether this technique was an appropriate technique for portal hypertension due to liver cirrhosis, patients contraindicated for the treatment should be carefully identified to avoid the complications.
脾肿大/脾功能亢进是门静脉高压最常见的并发症之一。脾动脉栓塞术（SAE）已越来越多地用于治疗脾肿大/脾功能亢进。然而，很少有研究关注栓塞后的严重并发症。在本文中，我们报告了16例门静脉高压患者SAE术后严重并发症的病例。
2011年2月至2019年1月，16例肝硬化患者被诊断为栓塞术后严重并发症。对其临床症状、治疗方法及预后进行分析。
这些患者的脾脏栓塞体积在50%至70%之间。16例患者中，7例被诊断为脾脓肿和/或左膈下脓肿，持续发热，最终接受手术治疗；6例出现顽固性左侧胸腔积液，严重胸闷，接受反复胸腔穿刺或胸腔闭式引流；3例门静脉血栓形成患者需要口服华法林治疗。
在肝硬化患者中，SAE术后严重并发症并不少见。这给这些患者带来了更多痛苦、延长了住院时间并增加了医疗费用。由于肝硬化，这项技术是否是治疗门静脉高压的合适技术存在争议，应仔细识别禁忌治疗的患者以避免并发症。
