摘要
目的 探讨脾脏毁损体积对射频消融（Radiofrequency Ablation，RFA）治疗肝硬化门脉高压性脾功能亢进症近期疗效的影响。方法 对28例肝炎后肝硬化门静脉高压脾功能亢进症患者进行RFA治疗。分别在RFA术后1、7、14、30、60、180、360d，检测外周血WBC、RBC、PLT变化。增强CT测定脾脏毁损体积，根据脾脏毁损体积百分比将患者分成4组：Ⅰ组（〈300）、Ⅱ组（30％～500）、Ⅲ组（500～60％），Ⅳ组（〉600），各组间进行对比分析。结果 RFA术后WBC、PLT呈明显上升趋势，术后360d与术前比较差异有统计学意义（P〈0．01）。脾脏平均毁损体积为（38．20±17．36）％。毁损体积500～600组术后360 d WBC、PLT较〈30％组、30％～50％组及〉60％组上升明显（P〈0．01）。结论 临床上应用射频消融治疗门脉高压性脾功能亢进症的近期疗效肯定。毁损脾脏50％～60％体积近期疗效较好。
Objective To investigate the influence of spleen ablation volume on clinical effect of radiofrequency ablation （RFA）in treatment of hypersplenism. Methods Twenty-eight cases with posthepatitic cirrhosis, portal hypertension and hypersplenism were treated with RFA, after which the changes of white blood cell （WBC）, red blood cell （RBC） and platelet （PLT） of the peripheral blood were detected at days 1, 3, 7, 14, 30, 60 and 180 respectively with automatic hemocyte analysor. The spleen ablation volume was determined by enhanced CT to compare clinical effect of RFA at various volumes in treating hypersplenism. Results WBC and PLT presented a significant elevation tendency. There was significantly statistical difference at every time points compared with preoperation （ P 〈0.01）. The average spleen ablation volume was （38.20±17.36） %. At day 80 after RFA, WBC and PLT in group with spleen ablation volume for 50%-60% increased more significantly those in group with spleen ablation volume for 30%- 50% or below 30% （ P 〈0.01）. Conclusions RFA has positive short-term curative effect on portal hypertensive hypersplenism, especially for cases with spleen ablation volume at around 60%.
出处
《消化外科》
CSCD
2006年第3期191-193,共3页
Journal of Digestive Surgery
关键词
脾功能亢进
射频消融
Hypersplenism
Radiofrequency ablation
