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目的 探讨肝动脉化疗栓塞联合部分性脾动脉栓塞 (PSE)治疗原发性肝癌合并脾功能亢进的意义及方法。方法 原发性肝癌合并脾亢 3 1例 ,采用经皮穿刺肝动脉化疗栓塞术 (TACE)和PSE治疗 ,治疗前后测定血细胞数量 ,CT观察肝脏肿瘤及脾脏大小改变。结果 PSE术后 2 4h、1周、4周血白细胞和血小板均较栓塞前明显升高 (Ρ <0 .0 1)。 2 8例脾栓塞面积在 40 %～70 % ,2例 80 % ,1例 <40 %。术后 1月CT复查肝脏肿瘤缩小 2 2例 ,占 70 .97% (2 2 / 3 1)。脾脏有所缩小 ,内可见均一低密度梗死区。结论 肝动脉化疗栓塞及部分性脾动脉栓塞是治疗肝癌合并肝硬化脾功能亢进安全、有效的方法
Objective To investigate the significance and methods of hepatic arterial chemoembolization combined with partial splenic arterial embolization (PSE) in the treatment of primary hepatocellular carcinoma complicated with hypersplenism. Methods Thirty-one patients with hepatocellular carcinoma complicated with hypersplenism were treated with percutaneous transhepatic arterial chemoembolization (TACE) and PSE. The number of blood cells was measured before and after treatment. The tumor size and spleen size were observed by CT. Results The levels of leukocyte and platelet were significantly higher at 24 h, 1 week and 4 weeks after PSE than before embolization (P <0.01). 28 cases spleen embolization area of 40% to 70%, 2 cases 80%, 1 case <40%. On January 1, CT examination of liver tumors showed a decrease of 22 cases, accounting for 70.97% (2 2/3 1). The spleen has been reduced, showing uniform low-density infarct area. Conclusions Transcatheter arterial chemoembolization and partial splenic arterial embolization are safe and effective methods for the treatment of liver cancer complicated with liver cirrhosis and hypersplenism