【摘要】：目的通過(guò)CT分析,探討脾功能亢進(jìn)患者部分脾動(dòng)脈栓塞術(shù)(PSE)后栓塞脾組織的變化及其對(duì)機(jī)體康復(fù)的影響。方法收集該院接受PSE治療的脾功能亢進(jìn)患者46例,在PSE治療后1周、1個(gè)月、3個(gè)月及6個(gè)月復(fù)查上腹部CT平掃聯(lián)合增強(qiáng)掃描,同時(shí)采血復(fù)查肝功能及血常規(guī)。將PSE治療后1周的CT圖像運(yùn)用CT自帶的Volume功能軟件計(jì)算脾臟的栓塞比例,將栓塞比例小于等于50%的患者共31例作為A組,其余15例栓塞比例大于50%的患者作為B組。記錄患者行PSE治療后的住院時(shí)間、外周血細(xì)胞升高持續(xù)時(shí)間以及各觀察期被栓塞脾組織的CT圖像表現(xiàn)。結(jié)果栓塞脾組織的CT變化:術(shù)后1周所有患者均表現(xiàn)為梗死;術(shù)后1個(gè)月12例患者表現(xiàn)為梗死,其中有4例伴有液化表現(xiàn),其余34例出現(xiàn)修復(fù)表現(xiàn);術(shù)后3個(gè)月19例患者表現(xiàn)為完全修復(fù),其余27例患者表現(xiàn)為部分修復(fù),其中有8例患者有梗死伴液化表現(xiàn);術(shù)后6個(gè)月42例患者表現(xiàn)為完全修復(fù),其余4例患者表現(xiàn)為部分修復(fù),同時(shí)有梗死伴液化表現(xiàn)。栓塞脾組織CT表現(xiàn)為部分修復(fù)的情況比較,在PSE治療后1個(gè)月,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05);栓塞脾組織修復(fù)程度的比較,在PSE治療后3個(gè)月,兩組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PSE治療后住院時(shí)間比較,A組與B組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PSE治療后患者外周血細(xì)胞升高持續(xù)時(shí)間比較,A組與B組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 PSE治療脾功能亢進(jìn),栓塞比例的大小將會(huì)影響栓塞脾組織在不同時(shí)期的CT變化;PSE治療后,栓塞脾組織的CT圖像會(huì)有梗死、部分修復(fù)、梗死伴液化、完全修復(fù)的變化過(guò)程,這些變化過(guò)程將會(huì)對(duì)PSE治療脾功能亢進(jìn)的效果及治療后的住院時(shí)間產(chǎn)生影響。
[Abstract]:Objective to investigate the changes of spleen tissue after partial spleen artery occlusion (PSE) in patients with hyperplenism and its effect on rehabilitation by CT analysis. Methods 46 patients with hypersplenism treated with PSE were collected. One week, one month, three months and six months after PSE treatment, the upper abdominal CT plain scan combined with enhanced scan was reexamined, and the liver function and blood routine were examined at the same time. One week after PSE treatment, CT images were used to calculate the proportion of spleen embolism with CT's own Volume function software. 31 patients with embolism ratio less than or equal to 50% were taken as group A, and the other 15 patients with embolism ratio greater than 50% were treated as group B. The hospitalization time, the duration of peripheral blood cell elevation and the CT images of embolized spleen tissue were recorded after PSE treatment. Results the changes of CT in embolic spleen tissue: all the patients showed infarction 1 week after operation, 12 patients showed infarction 1 month after operation, 4 of them were accompanied by liquefaction, and the other 34 showed repair. At 3 months after operation, 19 patients showed complete repair, the other 27 patients showed partial repair, of which 8 patients had infarction with liquefaction. At 6 months after operation, 42 patients showed complete repair, the other 4 patients showed partial repair, and infarction with liquefaction. The CT findings of embolic spleen tissue were compared with those of partial repair. One month after PSE treatment, there was significant difference between the two groups (P 0.05). There was significant difference in the degree of repair of embolic spleen tissue between the two groups 3 months after PSE treatment (P 0.05). There was significant difference between group A and group B (P 0.05). After PSE treatment, there was significant difference in the duration of peripheral blood cell elevation between group A and group B. there was significant difference between group A and group B (P 0.05). Conclusion in the treatment of hypersplenism with PSE, the proportion of embolism will affect the changes of CT in spleen tissue in different periods. After PSE treatment, the CT images of embolized spleen tissue will have the process of infarction, partial repair, infarction with liquefaction and complete repair, which will have an impact on the effect of PSE in the treatment of hypersplenism and the length of hospitalization after treatment.
【作者單位】： 遵義醫(yī)學(xué)院附屬醫(yī)院介入科;
【分類號(hào)】：R551.1;R575.2

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