脾动脉高选择性插管部分脾栓塞术治疗肝炎肝硬化并发脾功能亢进症患者临床疗效研究*

doi:10.3969/j.issn.1672-5069.2026.05.019

摘要/Abstract

摘要： 目的研究脾动脉高选择性插管部分脾栓塞术(PSE)治疗肝硬化并发脾功能亢进症患者的临床疗效。方法 2023年2月～2025年5月我院收治的肝炎肝硬化并发脾功能亢进症患者96例,其中42例接受脾切除联合门奇静脉断流术治疗,另54例接受脾动脉高选择性插管PSE治疗。使用多普勒超声诊断仪测定门静脉内径(PVD)和门静脉血流量(PVF)。结果在术后3个月,脾栓塞组血小板计数(PLT)和红细胞计数分别为(108.6±32.4)×10⁹/L和(3.6±0.8)×10¹²/L,均显著低于脾切除组[分别为(126.9±28.7)×10⁹/L和(4.2±0.8)×10¹²/L,P<0.05];两组肝功能指标及PVD和PVF变化均无统计学差异(P>0.05);脾栓塞组并发症发生率为16.7%,显著低于脾切除组的33.3%(P<0.05),且脾切除术治疗组门静脉血栓发生率为9.5%。结论脾动脉高选择性插管PSE治疗肝炎肝硬化并发脾功能亢进症患者也能在一定程度上缓解血细胞减少,而临床严重并发症发生率较低,值得进一步研究。

关键词: 肝硬化, 脾功能亢进症, 部分脾栓塞术, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of partial splenic embolization (PSE) based on highly selective catheterization of splenic artery in the treatment of patients with liver cirrhosis. Methods 96 patients with hepatitis B- or C-induced liver cirrhosis were encountered in our hospital between February 2023 and May 2025, and splenectomy and pericardial devascularization were conducted in 42 cases and PSE supported by highly selective catheterization of splenic artery was performed in another 54 cases. Portal vein diameter (PVD) and portal vein flow (PVF) were measured by Doppler ultrasonic diagnosis apparatus. Results By end of three-month after operation, platelet and red blood cell counts in PSE-treated patients were (108.6±32.4)×10⁹/L and (3.6±0.8)×10¹²/L,both much lower than [(126.9±28.7)×10⁹/L and (4.2±0.8)×10¹²/L,respectively, P<0.05] in splenectomy-treated patients; there were no significant differences as respect to liver function tests, PVD and PVF changes between the two groups (P>0.05); post-operationally, incidences of complications in PSE-treated patients was 16.7%,much lower than 33.3%(P<0.05) in splenectomy-treated patients,and portal thrombosis occurred in four cases (9.5%) in the latter group. Conclusion PSE based on highly selective catheterization of splenic artery in the treatment of patients with liver cirrhosis also oculd ameliorate hypersplenism to some intent, with less severe adverse effects and warrants further clinical investigation.

Key words: Liver cirrhosis, Hypersplenism, Partial splenic embolization, Highly selective catheterization, Therapy

茹秀峰, 秦琳, 董小平, 李振平, 何锦来, 胡永辉. 脾动脉高选择性插管部分脾栓塞术治疗肝炎肝硬化并发脾功能亢进症患者临床疗效研究^*[J]. 实用肝脏病杂志, 2026, 29(5): 713-716.

Ru Xiufeng, Qin Lin, Dong Xiaoping. Partial splenic embolization based on highly selective catheterization of splenic artery in the treatment of patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2026, 29(5): 713-716.

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脾动脉高选择性插管部分脾栓塞术治疗肝炎肝硬化并发脾功能亢进症患者临床疗效研究^*

Partial splenic embolization based on highly selective catheterization of splenic artery in the treatment of patients with liver cirrhosis

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