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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (7): 79-83.doi: 10.6040/j.issn.1671-7554.0.2016.1619

• 临床医学 • 上一篇    下一篇

部分脾栓塞联合腹腔镜下射频消融术治疗门脉高压性脾功能亢进的临床研究

杜福田1,杜云龙2,林洪峰1   

  1. 1.潍坊市人民医院肝胆外科, 山东 潍坊 261041;2.淄博市第一医院普外三科, 山东 淄博 255000
  • 收稿日期:2016-12-06 出版日期:2017-07-10 发布日期:2017-07-10
  • 通讯作者: 杜福田. E-mail:dft641016@163.com E-mail:dft641016@163.com
  • 基金资助:
    潍坊市科技发展计划(2014WS0015)

A clinical research on occlusive techniques for partial splentic embolization combined with radiofrequency ablation for hypersplenism due to portal hypertension

DU Futian1, DU Yunlong2, LIN Hongfeng1   

  1. 1. Department of Hepatobiliary Surgery, Weifang Peoples Hospital, Weifang 261041, Shandong, China;
    2. Third Department of General Surgery, First Hospital of Zibo, Zibo 255000, Shandong, China
  • Received:2016-12-06 Online:2017-07-10 Published:2017-07-10

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摘要： 目的 观察部分脾栓塞(PSE)联合腹腔镜下射频消融(RFA)治疗门脉高压性脾功能亢进的临床治疗效果。 方法 对门脉高压性脾功能亢进患者69例,分别采用PSE联合腹腔镜下RFA(26例,A组)与脾切除术(43例,B组)这两种方法,分析所取得的不同临床治疗效果。 结果 A组患者住院过程中无手术及治疗相关的死亡率,主要并发症有左上腹部疼痛不适(16例),发热(10例),胸腔积液(1例)。B组患者住院过程中无手术及治疗相关的死亡率,主要并发症有发热(29例),腹腔出血(3例),胸腔积液(7例),门脉栓塞(6例)。两组比较,术后并发症发生率A组明显低于B组,差异有统计学意义。 结论 部分脾动脉栓塞联合腹腔镜下射频消融对治疗肝硬化性门脉高压性脾功能亢进有较好的治疗效果和重要的临床应用价值,是治疗肝硬化性门脉高压性脾功能亢进安全而有效的微创治疗手段。

关键词: 脾动脉, 门脉高压, 脾功能亢进, 射频消融术

Abstract: Objective To observe the clinical efficacy of partial splentic embolization(PSE)technique combined with laparoscopic radiofrequency ablation(RFA)in the treatment of hypersplenism in patients with portal hypertension. Methods A total of 69 patients with portal hypertension and hypersplenism were treated with PSE combined with laparoscopic RFA(n=26, group A)and splenectomy(n=43, group B). The clinical outcomes were analyzed and compared. Results No procedure-related death occurred in group A. The major complications were left upper abdominal pain(16 cases), fever(10 cases)and pleural effussion(1 case). No procedure-related death occurred in group B either. The major complications included fever(29 cases), abdominal cavity hemorrhage(3 cases), pleural effusion(7 cases), and portal vein thrombosis(6 cases). The incidence of postoperative complications was significantly lower in group A than in group B. Conclusion Splenic artery embolization combined with laparoscopic radiofrequency ablation has good curative effect and important clinical value in the treatment of hypersplenism in patients with portal hypertension. It is a safe, effective and minimally invasive.

Key words: Portal hypertension, Radiofrequency ablation, Hypersplenism, Splenic artery

中图分类号: 

  • R657.6+3
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