曹俊杰, 羊茂荣. 螺旋CT评估脾功能亢进部分脾动脉栓塞术后的动态演变价值[J]. 蚌埠医学院学报, 2021, 46(5): 657-660. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.025
    引用本文: 曹俊杰, 羊茂荣. 螺旋CT评估脾功能亢进部分脾动脉栓塞术后的动态演变价值[J]. 蚌埠医学院学报, 2021, 46(5): 657-660. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.025
    CAO Jun-jie, YANG Mao-rong. Value of spiral CT in evaluating the dynamic evolution of hypersplenism after partial splenic embolization[J]. Journal of Bengbu Medical College, 2021, 46(5): 657-660. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.025
    Citation: CAO Jun-jie, YANG Mao-rong. Value of spiral CT in evaluating the dynamic evolution of hypersplenism after partial splenic embolization[J]. Journal of Bengbu Medical College, 2021, 46(5): 657-660. DOI: 10.13898/j.cnki.issn.1000-2200.2021.05.025

    螺旋CT评估脾功能亢进部分脾动脉栓塞术后的动态演变价值

    Value of spiral CT in evaluating the dynamic evolution of hypersplenism after partial splenic embolization

    • 摘要:
      目的对肝硬化脾功能亢进部分脾动脉栓塞(partial splenic embolization,PSE)术后病人进行中期随访,比较术中不同栓塞体积百分比病人术后栓塞区及脾组织的CT变化、外周血细胞变化及并发症发生情况。
      方法选取肝硬化脾功能亢进行PSE治疗的病人43例,根据脾脏栓塞体积百分比分为A组(≤50%)和B组(>50%)。比较2组病人术前和术后1周、4周、10周及6个月的上腹部CT表现、外周血细胞变化及并发症发生情况。
      结果A组在术后4周有1例有液化坏死,术后6个月均修复;B组在术后4周有5例有液化坏死,术后10周有7例有液化坏死,术后6个月有5例有液化坏死;2组术后4周、10周、6个月脾脏组织修复程度差异均有统计学意义(P < 0.05)。PSE术前后2组病人白细胞计数、红细胞计数、血小板计数差异均无统计学意义(P>0.05)。A组并发症发生率(41.38%)低于B组(71.42%)(P < 0.05)。
      结论螺旋CT可显示病人PSE术后脾脏栓塞区域及脾脏体积大小变化,评估术后并发症风险,PSE术中栓塞体积百分比≤50%更有利于病人术后恢复。

       

      Abstract:
      ObjectiveTo make a mid-term follow-up for patients with cirrhosis and hypersplenism after partial splenic embolization(PSE), and to compare the changes of CT, peripheral blood cells and complications in embolization area and spleen tissue of patients with different percentage of embolic volume.
      MethodsForty-three patients with cirrhosis and hypersplenism treated with PSE were divided into group A(≤ 50%) and group B(>50%) according to the percentage of splenic embolization volume.The CT manifestations of upper abdomen, the changes of peripheral blood cells and the occurrence of complications were compared between the two groups before operation, 1 week, 4 weeks, 10 weeks and 6 months after operation.
      ResultsLiquefaction necrosis was found in 1 case in group A at 4 weeks after operation and repaired at 6 months after operation; 5 cases of liquefaction necrosis at 4 weeks after operation, 7 cases at 10 weeks after operation, 5 cases at 6 months after operation in group B were found; and there were significant differences in the repair degree of spleen tissue between the two groups at 4 weeks, 10 weeks and 6 months after operation(P < 0.05).There were no significant differences in white blood cell count, red blood cell count and platelet count between the two groups before and after PSE(P>0.05).The incidence of complications in group A(41.38%) was lower than that in group B(71.42%)(P < 0.05).
      ConclusionsSpiral CT can show the changes of splenic embolization area and spleen volume after PSE, and evaluate the risk of postoperative complications.The percentage of embolization volume less than 50% during PSE is more helpful for postoperative recovery.

       

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