原发性肝癌合并脾功能亢进肝脾动脉双栓塞术应用分析.docVIP

原发性肝癌合并脾功能亢进肝脾动脉双栓塞术应用分析 　　[摘要] 目的：分析联合应用肝动脉栓塞术和部分脾动脉栓塞术治疗原发性肝癌伴脾功能亢进的临床应用价值。方法：本组对46例原发性肝癌伴脾功能亢进患者行肝动脉化疗栓塞术（TACE）同时行部分性脾动脉栓塞术（PSE），观察术前术后血象变化情况。结果：TACE联合PSE治疗原发性肝癌合并脾功能亢进可明显改善患者外周血象，术后3 d、1周、2周及4周外周血白细胞及血小板较栓塞前明显提高。结论：对于原发性肝癌合并脾功能亢进患者，在行肝动脉栓塞术同时行部分脾动脉栓塞术，安全可靠，既能有效控制肿瘤发展，又能有效改善患者血象，提高机体免疫力和患者的生活质量，降低了肝癌合并脾功能亢进介入治疗的风险，从而有效保证了化疗栓塞的安全性、有效性、合理性。 　　[关键词] 原发性肝癌；脾功能亢进；介入性治疗；栓塞 　　[中图分类号] R735.7 [文献标识码]B[文章编号]1674-4721（2011）06（b）-105-02 　　 　　Embolization of both hepatic and splenic arteries in primary hepatic carcinoma with hypersplenism 　　JIN Long 　　Department of Interventional Radiology, Yanbian Tumor Hospital, Jilin Province, Yanji 133000, China 　　[Abstract] Objective: To analyze the value of partial splenic embolization and transcatheter arterial chemoembolization in primary hepatic carcinoma with hypersplenism. Methods: There were forty-six cases of hepatic carcinoma with hypersplenism which were treated by transcatheter arterial chemoembolization and partial splenic embolization, observing the change of blood count before and after the operation. Results: To obviously improve the blood count of all patients by transcatheter arterial chemoembolization and partial splenic embolization, such as WBC and PLT were increased after the 3 days and several weeks. Conclusion: Transcatheter arterial chemoembolization and partial splenic embolization are safe in primary hepatic carcinoma with hypersplenism, they have the effect controlling development of primary hepatic carcinoma, increasing blood cell counts, elevating immunity and improving living quality，and reduce the risk of intervention treatment of hepatic carcinoma with hyperspleism, thus the safety, effectiveness and rationality of chemoembolization can be guaranteed. 　　[Key words] Primary hepatic carcinoma; Hypersplenism; Interventional therapy; Embolization 　　 　　原发性肝癌是世界上尤其是我国最常见的恶性肿瘤之一。手术切除是根治肝癌的有效方法，但大部分患者因多发病灶、病灶离大血管或大胆管近无法切除、多发肿瘤的不良生物学特性、合并肝硬化导致肝功能无法耐受手术等而失去了手术机会[1]。经导管肝动脉化疗栓塞术（transcatheter arte-rial che