论文部分内容阅读
目的 评价原发性肝癌合并脾亢行双介入治疗的疗效及其临床意义。方法 原发性肝癌合并脾亢患者 7例。均为男性 ,平均年龄 5 1岁 ,均有乙肝病史 15～ 2 0年 ,有肝硬化、脾肿大 ,6例为巨块型肝癌 ,1例为结节型 ,临床分期 :6例为Ⅱ期 ,1例为Ⅲ期 ;肝功能分级 :A级 4例 ,B级 3例 ;术前血小板计数为 :3 8± 14× 10 9/L ,伴白细胞减少 3例 :3 .6± 0 .1× 10 9/L ,红细胞减少 1例 :2 .73× 10 12 /L ,手术方式 :先行部分性脾栓塞 (PSE) ,然后行经导管肝动脉栓塞化疗术(THACE)。结果 术后 1～ 3天WBC :14 .2± 2 .8× 10 9/L ,BPC :5 3± 4× 10 9/L ;5～ 7天为 7± 1.7× 10 9/L ,10 3± 10×10 9/L ;术后第 14天 ,RBC为 :4.2 3× 10 12 /L(RBC减少者 )。术后一月复查CT :肝癌缩小约 3 0～ 40 % ,脾脏有所缩小 ,坏死区呈均匀坏死状态 ,肝功能有所改善。结论 双介入治疗原发性肝癌合并脾亢具有确切疗效 ,且有很重要的临床意义
Objective To evaluate the efficacy and clinical significance of double interventional therapy for primary hepatocellular carcinoma complicated with hypersplenism. Methods 7 cases of primary liver cancer complicated with hypersplenism. All were male, with an average age of 51 years. All had a history of hepatitis B from 15 to 20 years. Cirrhosis and splenomegaly were observed. Six cases were massive liver cancer and one case was nodular. The clinical stage was 6 Stage 1, stage Ⅲ; Liver function grading: A grade in 4 cases, B grade in 3 cases; Preoperative platelet count was: 38 ± 14 × 10 9 / L, with leukopenia in 3 cases: 3. 6 ± 0. 1 × 10 9 / L, 1 case of erythrocyte reduction: 2.73 × 10 12 / L, operation mode: partial splenic embolization (PSE) and then transcatheter hepatic arterial chemoembolization (THACE). Results WBC was 14.2 ± 2. 8 × 10 9 / L after 1 ~ 3 days of operation, 5 ± 4 × 10 9 / L of BPC, 7 ± 1.7 × 10 9 / L for 5 ~ 7 days, ± 10 × 10 9 / L; on the 14th postoperative, RBC was 4.2 3 × 10 12 / L (RBC reduction). One month after the review CT: liver cancer reduced about 30% to 40%, the spleen has been reduced, the necrosis area was uniform necrosis, liver function improved. Conclusion Double interventional treatment of primary hepatocellular carcinoma with hypersplenism has the exact effect, and has very important clinical significance