摘要
目的探讨脾动脉分支血管直径比值法计算脾脏栓塞体积的临床应用价值。方法回顾性分析20例接受部分脾动脉栓塞术治疗的肝硬化合并脾功能亢进患者的资料。根据术中脾动脉的血管造影图像,测量脾动脉分支血管的直径并计算脾脏栓塞体积百分比。对所有患者均于术后1个月行增强CT检查,并基于VR重建图像计算脾脏栓塞体积百分比。观察术后并发症及不良反应情况,于术前3天、术后1周、1个月、3个月检测外周血红细胞、白细胞及血小板,并进行统计学分析。结果部分脾动脉栓塞术中采用脾动脉分支血管直径比值法计算脾脏栓塞体积百分比[(52.15±3.29)%]与术后1个月CT测量栓塞体积百分比[(49.99±6.02)%]差异无统计学意义(t=-1.630,P=0.120)。所有患者术后均出现中度或中度以下左上腹疼痛,并出现恶心、呕吐、发热症状,均经对症治疗后好转。术前3天、术后1周、1个月、3个月外周血外周血红细胞、白细胞及血小板差异均有统计学意义(P均<0.001)。结论部分脾动脉栓塞术中应用脾动脉分支血管直径比值法评估脾脏栓塞体积,简便、实时且较为准确,值得临床推广应用。
Objective To explore the clinical application value for calculating the volume of splenic embolization by splenic artery branch diameter ratio method. Methods Data of 20 patients with cirrhosis and hypersplenism who underwent partial operation of splenic artery embolization were retrospectively analyzed. Based on the angiography of splenic artery during op- eration, the diameter of branch vessels of splenic artery was measured and the percentage of embolism volume in spleen was calculated. CT scans were performed on all patients after one month of the operations. Based on VR reconstruction image, the percentage of embolism volume in the spleen was calculated. Postoperative complications and adverse responses were observed. Peripheral blood red cells, white blood cells and platelets were tested repetitively three days before the operation, and a week, a month, three months after the operation. Moreover, the statistical analysis was performed. Results The difference between the percentage of embolism volume in the spleen calculated by splenic artery branch diameter ratio method （[52.15±3.29]%） and calculated byCT （[49.99±6.02]%） was not statistical （t=1.630, P=0.120）. All thepa dents had moderate or below moderate pain on left upper quadrant, and had symptoms of nausea, vomiting and fever after the operation. They all got better after symptomatic treatment. Peripheral blood red cells, white blood cells and platelets all had significant differences among three days before the operation, a week, a month and three months after the operation （all P〈0. 001）. Conclusion During the partial splenic embolization, the application of ratio method on branch vessels of splenic artery to measure the volume of embolism in the spleen is convenient, prompt and relatively accurate. It is worthy to be expanded in clinic.
出处
《中国介入影像与治疗学》
CSCD
北大核心
2017年第8期468-471,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
脾动脉
栓塞体积
明胶海绵
脾功能亢进
Splenic artery
Embolization volume
Gelatin sponge
Hypersplenism
