摘要
目的评估经皮微创消融联合脾切除术序贯治疗合并重度门静脉高压脾功能亢进的小肝癌的疗效和安全性。方法从2006年6月～2008年6月,我科收治的11例小肝癌合并门脉高压,脾功能亢进。我们先行脾切除术,术后恢复11天～4月后行PRFA或PMCT术治疗,术后随访肝功能、血常规、CT或MRI、AFP等。结果除1例脾切除术后出现胰漏,继发感染,给予抗生素冲洗、置管引流后恢复,于4月后行PMCT术,所有患者行微创消融无严重并发症,术后3～5天出院。结论对于重度肝硬化、门脉高压合并脾功能亢进的小肝癌病人,先行脾切除和(或)门奇静脉断流术,血小板及PT等指标改善后行经皮肝穿刺微创治疗是一种安全可行的治疗方法。
objective To evaluate effect and safety of the Sequential therapy of percutaneous microtrauma ablation with splenectomy for small liver cancer with severe portal hypertension and hepersplenism. Methods： From June 2006 to June 2008, we adopted 11 patients who had small liver cancer with portal hypertension and hypersplenism. We operated splenectomy first, and then did PRFA or PMCT. And then we tested the liver function blood routine CT scan or MRI scan and so on. Results： One patient occurred postoperative pancreatic leakage and secondary infection, which was cured after antibiotics therapeutics and tube drain and received PMCT after 4 months. All others were discharged in 3-5days after operation with no complication.Conclusions： It is a safe and feasible curative method for small liver cancer with severe portal hypertension and hepersplenism to do splenectomy and （or） portal azygous disconnection first,and then receive percutaneous ablation after the index such as platelet, PT and so on, improved.
出处
《当代医学》
2009年第11期178-179,共2页
Contemporary Medicine
关键词
小肝癌
微创治疗
脾功能亢进
脾切除术
small liver cancer
microinvasive therapy
hypersplenism
splenectomy
