CAJ | 학술논문

目的：探讨使用海藻酸钠微球蛋白进行脾脏部分栓塞治疗肝硬化所致脾功能亢进的临床疗效。方法对62例因肝硬化门静脉高压所致脾功能亢进的患者，以海藻酸钠微球蛋白进行脾脏部分栓塞治疗，平均随访（38.2±15.7）个月（1～60个月），收集相关临床数据，观察临床疗效、术后并发症和手术前后血细胞的变化。采用线性回归分析判断治疗1年后白细胞（WBC）和血小板（PLT）数量与临床数据的相关性。结果平均每位患者的栓塞面积约50%～70%，治疗后WBC和PLT数量迅速增高，1～2周后到达高峰然后缓慢下降，但仍较治疗前高。所有的患者都有不同程度的一过性发热和轻微胸痛，8个患者体温超过39℃，1例患者发生脾窝脓肿，1例患者出现反应性胸水。栓塞面积的比例与术后1年的 PLT 和WBC数量呈正相关。结论以海藻酸钠微球蛋白作为一种栓塞剂治疗脾功能亢进安全有效，具有较高的临床价值。
목적：탐토사용해조산납미구단백진행비장부분전새치료간경화소치비공능항진적림상료효。방법대62례인간경화문정맥고압소치비공능항진적환자，이해조산납미구단백진행비장부분전새치료，평균수방（38.2±15.7）개월（1～60개월），수집상관림상수거，관찰림상료효、술후병발증화수술전후혈세포적변화。채용선성회귀분석판단치료1년후백세포（WBC）화혈소판（PLT）수량여림상수거적상관성。결과평균매위환자적전새면적약50%～70%，치료후WBC화PLT수량신속증고，1～2주후도체고봉연후완만하강，단잉교치료전고。소유적환자도유불동정도적일과성발열화경미흉통，8개환자체온초과39℃，1례환자발생비와농종，1례환자출현반응성흉수。전새면적적비례여술후1년적 PLT 화WBC수량정정상관。결론이해조산납미구단백작위일충전새제치료비공능항진안전유효，구유교고적림상개치。
Objective To investigate the therapeutic effects of partial splenic embolization (PSE) with sodium alginate microspheres for hypersplenism caused by portal hypertension. Methods Sixty-two patients were treated with PSE during January 2004 and March 2010, due to thrombocytopenia caused by cirrhosis related hypersplenism. The clinical data were retrospectively collected, the mean follow-up time was (38.2±15.7) months (range, 1-60 months). A simple linear regression analysis was performed to determine the correlation between the clinical variables and the increase in platelet and leukocyte counts at one year. Results The embolization area was about 50%-70% for each patient, after therapy, the platelet and leukocyte counts increased immediately, reached a peak after one and two weeks respectively, then decreased slowly, however, the counts were still higher than before therapy. All of the patients experienced transient fever and mild left-sided chest pain,eight patients got high fever(more than 39.0℃). One patient was found to have a splenic abscess by abdominal Doppler ultrasound. One patient was affirmed to have pleural effusion by chest X-ray. The embolization ratio showed a positive correlation with the increase in platelet and leukocyte counts at one year after PSE. Conclusion Sodium alginate microspheres used as embolic agent to treat hypersplenism is promising because of its better long-term effect and low rate of severe postembolization syndrome.