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Clinical value of blood flow redistribute of coeliaca trunk artery in splenic embolization for patient with hypersplenisn, of hepatic cirrhosis.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
王兆华 尚璇 孙宝霞 梁传芳 王恂 龙启美
山东省枣庄市立医院 （277100）
Wang Zhao-hua, Shang Xuan, Sun Bao-xia, Liang Chuan-fang, Wnag Xun, Long Qi-mei, Zao Zhuang City Hospital, Zaozhuang 277100, China
Abstract
Objective：To study the clinical efficacy of splenic embolization(SPE)in patient with hypersplenism
Methods：30 patients were performed selective SPE with mixture of gelatin sponge and embolization for hypersplenism. Different periods of follow-up results were evaluated in all patients, hemodynamices, of lienalis and hepatica communis arterias were compared respectively ettween per and postembolization procedure. And hepatic artery iodied oil regetgeography was performed.
Results：Procedure was succeeded technically. In the period of 2-48 months follow-up, Hypersplenism relative clinical symptoms and sings were released in 29 patients And leukocyte and platelet counts inproved significantly. In 2 patients with premature small hepatocarcinoma and in 3 patients with diffuse nodular metastases were found by hepatic artery iodized oil regetgenography. Conc I us I on:
Conclusion：SPE for the treatment of hypersplenism is safe and effective.“Blood flowredistribute of coeliaca trunk artery”was advanced at first , Which has a sound efficacy improvement of hepatic functaon and ascites in patient with liver cirrhosis. It was significance tofind small hepatocarcinoma by hepatic artery iodized oil regetgenography.
key words：Hypersplenism, Embolization, I odized oil, Blood flow redistribute, small hepatocarcinoma.
脾机能亢进成因复杂，临床上我见于肝硬化的合并症。常表现为一种或多种血液有型成份减少，骨髓细胞增生活跃伴有脾肿大，门脉高压等体征。内科药科治疗效果不理想，传统外科脾切除术，创伤大，并发症多，风险高。近年来实施的脾动脉栓塞术（或称部分脾动脉栓塞术）。从理认到实践基本上探索出比较成熟的经验，疗效十分显著。本文就我院2000年1月至2004年8月实施的30例脾动脉栓塞术的技术操作及栓塞前后的处理报告如下：
材料与方法
一、临床资料
30例病人均有不同程度的肝硬化、脾肿大及出血倾向，肝功能clild分级：A级12例、B级10例、C级8例。B超、CT等影像学检查，脾脏肿大。化验检查白细胞、血小板减少，间或伴有轻度贫血。30例病人中男21女9，男女之比2：1。最小年龄13岁，最大年龄56岁。有消化道出血史1例。栓塞前均做骨髓穿刺，行骨髓细胞学检查，骨髓细胞增生活跃25例，骨髓细胞未见异常5例。合并肝癌者5例。其中2例为肝动脉碘化油造影所发现。栓塞后合并门静脉血栓者2例，其中一例行肠系膜上动脉间接门静脉溶栓治疗后血体溶解，另一例伴有消化道出血行胃底冠状静脉栓塞术而止血，一例女性病人，1月后复查，血小板、白细胞再度下降，基本无效。 | 
