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部分脾栓塞术治疗肝硬化脾功能亢进:临床疗效及肝功能评估

[Partial splenic embolization for the treatment of liver cirrhosis with hypersplenism: assessment of clinical response and liver function].

作者信息

Numata S, Akagi K, Sakino I, Ogata H, Kawadoko T, Suzuki N, Nomiyama K, Tsuji H, Fujishima M

机构信息

Department of Internal Medicine, Saiseikai Yahata General Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 1997 Aug;94(8):526-31.

PMID:9284441
Abstract

We have evaluated the efficacy of partial splenic embolization (SE) in the treatment in 10 cirrhotic patients with marked hypersplenism. The mean infarction rate of the spleen was 84%. The change of spleen size, peripheral blood cell counts and liver function tests after SE were investigated during 3 years, and also 10 cirrhotic patients without SE were followed as control. The residual spleens after SE did not enlarged except 1 case with 65% infarction rate of the spleen. In these cases, the SE led not only to a sustained increase in both platelet and white blood cell counts but also to a significant improvement of hepatic function tests (hepaplastin test, total cholesterol and albumin) during observation period. On the other hand, these parameters tended to decrease in control patients without SE. This study suggests that SE performed with a high infarction rate of spleen is an useful therapy for hypersplenism in cirrhosis.

摘要

我们评估了部分脾栓塞术(SE)对10例肝硬化伴明显脾功能亢进患者的治疗效果。脾脏平均梗死率为84%。在3年期间对SE术后脾脏大小、外周血细胞计数及肝功能检查的变化进行了研究,同时对10例未行SE的肝硬化患者进行随访作为对照。除1例脾脏梗死率为65%的病例外,SE术后残余脾脏未增大。在这些病例中,SE不仅使血小板和白细胞计数持续增加,而且在观察期内肝功能检查(肝促凝血酶原激酶试验、总胆固醇和白蛋白)有显著改善。另一方面,未行SE的对照患者这些参数有下降趋势。本研究表明,脾脏梗死率高的SE是治疗肝硬化脾功能亢进的一种有效疗法。

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