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目的:探讨经皮穿刺微波消融治疗肝硬化脾功能亢进症的安全性、疗效和临床应用前景。方法:2012年8月至2015年4月在超声引导下对50例(29例患者1次微波消融,12例患者重复2次微波消融,9例患者重复3次微波消融)肝硬化脾功能亢进症患者实施经皮穿刺脾脏微波消融治疗,对脾微波消融术过程中的术前及术后观察进行总结。结果:平均手术时间为(2.1±0.9)h,平均消融时间为(1.5±0.6)h;术后3 d外周血小板计数较术前明显下降;术后6个月随访发现患者白细胞以及血小板计数均较术前改善,差异有统计学意义(P<0.05),肝肾功能指标、凝血功能、红细胞计数无明显差异(P>0.05)。术后白细胞计数指标在Child-Pugh分组和消融次数分组中存在显著差异(P<0.05),术后血小板计数指标在消融次数分组和脾大程度分组中存在显著差异(P<0.05)。结论:经皮穿刺微波消融治疗肝硬化脾功能亢进症是一项具有临床应用前景的微创治疗方法,对患者白细胞及血小板指标的改善有显著作用。
Objective: To investigate the safety, efficacy and clinical application of percutaneous puncture microwave ablation in the treatment of liver cirrhosis and hypersplenism. Methods: From August 2012 to April 2015, 50 patients undergoing ultrasound guided microwave ablation (29 patients with one microwave ablation, 12 patients with repeated microwave ablation twice and 9 patients with repeated microwave ablation three times) had hypersplenism Patients underwent percutaneous microwave ablation of splenic microwave ablation, the process of microwave ablation of the spleen before and after surgery were summarized. Results: The average operation time was (2.1 ± 0.9) h and the mean ablation time was (1.5 ± 0.6) h. The peripheral platelet count decreased obviously 3 days after operation. The leukocyte count and platelet count Compared with preoperative, the difference was statistically significant (P <0.05), liver and kidney function, coagulation, red blood cell count was no significant difference (P> 0.05). The postoperative leukocyte count index was significantly different between Child-Pugh group and ablation frequency group (P <0.05). The postoperative platelet count index was significantly different between ablation frequency group and splenomegaly group (P <0.05). Conclusion: Microwave-assisted percutaneous microwave ablation of liver cirrhosis and hypersplenism is a minimally invasive treatment with clinical application prospect, which has a significant effect on the improvement of white blood cells and platelets in patients.