摘要
目的探讨肝动脉化疗栓塞(TACE)联合部分脾动脉栓塞(PSE)治疗原发性肝癌合并脾功能亢进(脾亢)的临床应用价值及意义。方法将10例明确诊断为原发性肝癌合并脾亢患者作为治疗组,在给予TACE的同时行PSE;并在同期患者中随机抽取10例仅诊断为原发性肝癌患者作为对照组。20例患者均有乙型肝炎病史;肝功能Child分级A、B、C级分别为12、7、1例。观察治疗组术后1周、1个月白细胞、血小板计数变化情况,以及治疗组与对照组术后1周、1个月肝功能损害情况。结果 20例患者均一次性插管成功,无术中、术后严重并发症发生。治疗组术后1周、1个月白细胞、血小板计数较术前有不同程度升高,差异有统计学意义(P<0.05);对照组术后1周丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)与术前比较,差异有统计学意义(P<0.01),总胆红素(TBIL)、清蛋白(Alb)及术后1个月肝功能与术前比较,差异无统计学意义(P>0.05)。治疗组术后1周、1个月肝功能与术前比较,差异无统计学意义(P>0.05)。结论TACE联合PSE治疗原发性肝癌合并脾亢,手术操作简便安全,对减轻术后肝功能的进一步损害、缓解脾亢临床效果满意,值得推广。
Objective To explore the clinical application value and significance of transcatheter arterial chemoem- bolization （TACE） combined with partial splenic embolization （PSE） in treating primary hepatic carcinoma （PHC） concurred with hypersplenism. Methods 10 patients with clear diagnosis of PHC concurred with hypersplenism were selected as treatment group ,which were treated with TACE combined with PSE;10 cases with diagnosis of PHC were selected from simultaneous pa- tients as control group. All the 20 patients had medical history of hepatitis B. According to the Child-Pngh, group A had 12 cases, group B had 7 cases and group C had 1 case. The changes of white blood cell count（WBC ） and blood platelet count（BPC ） in treat- ment group were observed 1 week and 1 month after treatment respectively, and the conditions of hepatic function damage in both groups were also observed 1 week and 1 month after operation respectively. Results All the 20 cases were successful of dispos- able intubation, there was no intraoperative and postoperative complications. Compared with before treatment, the WBC and BPC in treatment group increased in different degrees with statistically significant difference （P〈O.05）. The comparison of alanine amino- transferase （ALT） and aspartate aminotransferase （AST） in control group between 1 week after operation and before operation had statistically significant difference （ P〈0.01 ）, the total bilirubin （TBIL）, albumin （Alb） and hepatic function 1 month after operation had no statistically significant difference compared with those before operation （P〉O.05）. There was no statistically significant differ- ence in treatment group on hepatic funtion between 1 week and 1 month after operation and before operation （P〉0.05）. Conclu- sion Combination of TACE and PSE in treating PHC concurred with hypersplenism is easy and safe to be operate,its clinical ef- fect for further reducing the damage of hepatic function and relieving hypersplenism is satisfactory ,so it is worthy of clinical promotion.
出处
《现代医药卫生》
2013年第23期3523-3525,共3页
Journal of Modern Medicine & Health
关键词
肝肿瘤
脾功能亢进
化学栓塞
治疗性
肝动脉
肝硬化
高血压
门静脉
栓塞
治疗性
Liver neoplasms
Hypersplenism
Chemoembolization,therapeutic
Hepatic artery
Liver cirrho- sis
Hypertension,portal
Embolization,therapeutic
