打虎山老弟,我此前咨询过不少医生,脾动脉分支栓塞的确可以降低门脉压力。已有不少文献报道(用partial splenic embolization作关键词在百度或谷狗搜索)。我也查了一些文献。的确是可以降低门脉压力。当然降低门脉压力的效果肯定不如切脾。最初脾动脉栓塞是1973年开始的,那时候是做全脾动脉栓塞代替切脾,治疗门脉高压并发症,弊病是全栓塞后容易引起感染。部分栓塞是后来的事,当然部分栓塞的主要目的是改善血细胞,但的确可以不同程度降低门脉压力。这篇文章讲的比较详细。
Splenic artery embolization as an adjunctive procedure for portal hypertension
作者: wj2008 时间: 2018-4-25 23:02
原文:Recently, PSE has been developed into an alternative choice for the treatment of portal hypertension and hypersplenism. Portal vein pressure is decreased after PSE since blood flow from the splenic artery is reduced. In addition, liver function was reportedly improved by PSE, with cholinesterase activated and level of serum albumin increased [30].
翻译:最近,部分脾栓塞手术(PSE)被发展为为治疗门脉高压和脾亢的另外一种手段(译者注:主要手段是切脾。)研究显示:由于脾动脉部分栓塞后,进脾血流减少,导致自脾进入门脉的血流减少而降低门脉压力。此外,部分脾动脉栓塞也可以改善肝功能(比如激活胆碱酯酶,提升血清白蛋白浓度)
参考文献:
Kato M., Shimohashi N., Ouchi J., et al. Partial splenic embolization facilitates completion of interferon therapy in patients with chronic HCV infection and hypersplenism. Journal of Gastroenterology. 2005;40(11):1076–1077. doi: 10.1007/s00535-005-1693-x. 作者: 价值观007 时间: 2018-4-27 17:07