Tan Youwen, Wang Jiamin, Sun Li, Ye Yun
Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China.
Open Med (Wars). 2022 Apr 25;17(1):808-815. doi: 10.1515/med-2022-0479. eCollection 2022.
Splenic embolization is a minimally invasive alternative to splenectomy for the treatment of hypersplenism. This was a retrospective study of 101 patients with hypersplenism caused by cirrhosis who were treated with splenic embolization and for whom 6 months of follow-up data were available. Of these patients, 65 underwent partial splenic artery embolization (PSE), including 23 who underwent repeated PSE (RPSE). The incidence of abdominal pain was significantly higher in the PSE group than in the total splenic artery embolization (TSE) group ( < 0.001), and its duration was also longer in the PSE group ( = 0.003). Biochemical markers of liver function were compared before and after the operation; aminotransferase indices decreased (alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase), total bilirubin increased slightly, and albumin and prealbumin decreased after the operation (all < 0.001). Platelet (PLT) counts began to increase at 1 week postoperatively, peaked at 1 month postoperatively, and then decreased gradually. There was no significant intergroup (PSE and TSE) difference at any time point (1 day, 1 week, 1 month, and 6 months postoperatively, > 0.05). There was a significant intergroup (PSE and RPSE) difference in the mean postoperative change in PLT count ( = 0.45). Splenic embolization can improve the inflammatory indicators of liver function. Performing PSE twice or more improves the PLT counts.
脾栓塞术是一种用于治疗脾功能亢进的微创性脾切除术替代方法。这是一项对101例因肝硬化导致脾功能亢进且有6个月随访数据的患者进行的回顾性研究。在这些患者中，65例接受了部分脾动脉栓塞术（PSE），其中23例接受了重复部分脾动脉栓塞术（RPSE）。PSE组腹痛发生率显著高于全脾动脉栓塞术（TSE）组（<0.001），且PSE组腹痛持续时间也更长（=0.003）。对手术前后的肝功能生化指标进行了比较；术后转氨酶指标下降（丙氨酸转氨酶、天冬氨酸转氨酶和碱性磷酸酶），总胆红素略有升高，白蛋白和前白蛋白下降（均<0.001）。血小板（PLT）计数术后1周开始升高，术后1个月达到峰值，然后逐渐下降。在任何时间点（术后1天、1周、1个月和6个月），组间（PSE和TSE）均无显著差异（>0.05）。术后PLT计数的平均变化在组间（PSE和RPSE）存在显著差异（=0.45）。脾栓塞术可改善肝功能的炎症指标。进行两次或更多次PSE可提高PLT计数。
