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目的为临床观察采用肝动脉栓塞化疗联合部分脾动脉栓塞治疗原发性肝癌合并脾功能亢进的疗效。方法住院原发性肝癌伴肝硬化脾功亢进患者34例，采用经皮穿刺肝动脉插管化疗栓塞及脾动脉部分栓塞治疗，治疗前后测肝功、免疫指标、外周血及B超、CT等。结果术后CT随访显示肝脏瘤体缩小24例，占70．58％（24／34），其中缩小50％以上占13例，2例治疗后行二期手术切除；脾脏栓塞后CT复查缩小，最大34．7％，最小20．6％，AFP治疗后有不同程度下降，有23例治疗后肝功能改善，免疫指标治疗前后无大变化，动态监测治疗后外周血象，WBC、RBC、PT均有提高，其中PT治疗后明显升高（P＜0．01）。结论肝动脉及部分脾动脉栓塞伴化疗可使肝肿瘤缩小，脾功能亢进缓解，是中晚期肝癌伴肝硬化脾亢的有效治疗手段之一。
Objective To observe the clinical efficacy of hepatic artery embolization chemotherapy combined with partial splenic artery embolization in the treatment of primary liver cancer with hypersplenism. Methods Thirty-four patients with primary liver cancer and liver cirrhosis with hypersplenism were treated with percutaneous transhepatic arterial chemoembolization and partial embolization of the splenic artery. Liver function, immune parameters, peripheral blood, B-ultrasonography, and CT were measured before and after treatment. . Results Postoperative CT follow-up showed 24 cases of hepatic tumor shrinkage, accounting for 70.58% (24/34), of which 13 cases were reduced by more than 50%. Two cases were treated with surgical resection after the second stage; CT examination after splenic embolization was reduced. The maximum was 34.7% and the minimum was 20.6%. After AFP treatment, it decreased to some extent. There were 23 cases of liver function improvement after treatment, no significant changes before and after treatment of immune parameters, dynamic monitoring after treatment of peripheral blood, WBC, RBC, PT There was an increase, which was significantly higher after PT treatment (P<0.01). Conclusion Hepatic artery and partial splenic artery embolization with chemotherapy can reduce liver tumors and relieve hypersplenism. It is an effective treatment for middle-late stage liver cancer with liver cirrhosis and splenomegaly.