CAJ | 학술논문

目的：研究和分析对脾动脉不同部位的栓塞治疗不同疾病的临床效果和方法。方法：选择23例患者，肝硬化合并肝癌6例，单纯肝硬化门脉高压食道胃底静脉破裂出血13例，脾功能亢进4例，男19例，女4例。对19例患者采取脾动脉主干栓塞，而后4例患者作部分性脾实质栓塞(即对部分脾段动脉进行栓塞)。结果：13例肝硬化门脉高压食道-胃底静脉曲张破裂出血的患者于脾动脉主干栓塞后，出血立即停止，除1例栓塞1月后再次出血，1例因肾功能衰竭于栓塞术后48h死亡外，其余11例一年内未再次出血；6例肝癌行脾动脉主干栓塞后进行了肝癌的灌注栓塞(TACE)治疗，未发生术后上消化道出血；4例脾亢患者行脾段动脉栓塞后，第3天白细胞及血小板有明显升高，除左上腹疼痛及发热较明显外，无其他并发症。所有栓塞治疗比较安全。结论：通过动脉超选择性插管栓塞术，可以治疗脾亢及门脉高压引起的上消化道大出血，且保留了脾脏功能。所有治疗方法操作简单、安全有效，值得推广运用。
목적：연구화분석대비동맥불동부위적전새치료불동질병적림상효과화방법。방법：선택23례환자，간경화합병간암6례，단순간경화문맥고압식도위저정맥파렬출혈13례，비공능항진4례，남19례，녀4례。대19례환자채취비동맥주간전새，이후4례환자작부분성비실질전새(즉대부분비단동맥진행전새)。결과：13례간경화문맥고압식도-위저정맥곡장파렬출혈적환자우비동맥주간전새후，출혈립즉정지，제1례전새1월후재차출혈，1례인신공능쇠갈우전새술후48h사망외，기여11례일년내미재차출혈；6례간암행비동맥주간전새후진행료간암적관주전새(TACE)치료，미발생술후상소화도출혈；4례비항환자행비단동맥전새후，제3천백세포급혈소판유명현승고，제좌상복동통급발열교명현외，무기타병발증。소유전새치료비교안전。결론：통과동맥초선택성삽관전새술，가이치료비항급문맥고압인기적상소화도대출혈，차보류료비장공능。소유치료방법조작간단、안전유효，치득추엄운용。
Objective: To study the effect and method of embolization of splenic artery in different location for different diseases.Methods: Twenty-three cases were studied,including liver cancer with hepatocirrhosis in 6,esophageal and gastric varices hemorrhage secondary to portal hypertension in 13 and splenic hyperfunctioning in 4.Nineteen cases of 23 were embolized in the trunk of splenic artery,and other 4 cases in the splenic segmntal artery. Results: Esophageal varices hemorrhage in the total 13 cases was stanched immediately following splenic artery emlbolization. By which one of them bled again at one month,one died of renal failure in 48 hours,and in the remaining 11 cases there was no bleeding wihtin one year. Six cases of liver cancer underwent hepatic arterial chemo-embolization following splenic artery embolization, and no upper gastrointestinal hemorrhage occurred postoperatively. In 4 cases of splenic hyperfunctioning leucocytes and platelets increased 3 days after splenic segmental embolization. Conclusion: partial splenic artery embolization with preservation of the spleen function is a simple,safe and effective method for treating splenic hyperfunctioning and upper gastrointestinal hemorrhage secondary to portal hypertension.