| Objective:Quantitative 8spheres embolization microsphere was used for partial splenic artery embolization,and preoperative and postoperative splenic volume was measured to obtain quantitative embolization microsphere quantitative splenic volume,And To verify the safety and effectiveness of 8sphere embolized microspheres in partial splenic artery embolization,providing a safer and more effective treatment for patients with hypersplenism.Methods:This study is a single-center controlled clinical study.A total of 63 patients with hypersplenism in the first affiliated hospital of Kunming Medical University for PSE were collected.They were divided into two groups according to the size of the microspheres used,32 in group A(500-700 μm)and 31 in group B(700-900 μm).Contrast agent microsphere suspension was prepared by disposing two kinds of microspheres of different sizes.Both groups of patients met the inclusion criteria and signed the informed consent before surgery.Two groups of patients underwent CT enhanced scans before and 1 month after PSE.The post-processing VOLUME software was used to manually trace the spleen,calculate the spleen volume,and compare the angiographic assessment volume at different periods with the actual embolization rate.Follow-up was conducted on the third,seventh,January,march,June and December after the operation to observe the changes of platelets and white blood cells.The incidence of adverse events was counted during postoperative hospitalization,and the final follow-up date was March 2020.The baseline data,volume of splenic embolism,efficacy,and incidence of adverse reactions of the two groups were compared,and SPSS 21.0 software was used for statistical analysis.P<0.05 indicated that the difference was statistically significant.Results:1.Configure microsphere suspension and verify the homogeneity of the suspension:8Spheres(500-700μm)is configured as a total of 13ml suspension,the solution mass is 14.78g,the theoretical value of the unit volume of suspension mass=1.14g/ml.The 8Spheres(700-900μm)are configured as a total of 14ml of suspension solution,the solution mass is 16.6g,the theoretical value of the unit volume of suspension mass=1.19g/ml.Two groups were drawn 0.5ml;1ml;2ml microsphere suspension was compared with the theoretical value,the difference was not statistically significant.2.Volume of splenic embolism:In group A(500-700μm),the mean volume of 1g embolized microspheres was 449.4±125.79cm3,and the mean embolization rate was(40.1±12.2)%.In group B(700-900μm),The mean volume of 1g embolized microspheres was 555.16±117.46cm3,the mean embolization rate was(50.0±10.9)%.There were statistically significant differences in embolization volume and embolization rate between the two groups(P<0.05).Immediately after surgery,15 minutes after surgery,and 30 minutes after surgery,the embolic volume of patients in group A was(56.2±12.3)%;(49.8±12.8)%;(42.3±11.5)%,and the correlation coefficients are:0.79;0.81;0.907.Immediately after surgery,15 minutes after surgery,and 30 minutes after surgery,the embolic volume of patients in group B was(66.6±11.0)%;(59.1 ± 12.7)%;(52.2±12.2)%,and the correlation coefficients are 0.733;0.862;0.937.The postoperative delayed angiographic assessment of the embolization volume was positively correlated with the actual embolization volume.3.Peripheral blood cell changes:There was a statistically significant difference in the count of leukocytes in each period after operation between the two groups compared with that before operation(P<0.05).The white blood cells of group A patients can maintain normal levels within 3 months(WBC>4.0×109/L),and the white blood cells of group B patients can maintain normal levels within 6 months(WBC>4.0×109/L),The leucocyte level of group B was higher than that of group A on the 7th day,the 1st month and the 3rd month after the operation,and the difference was statistically significant(P<0.05).There were statistically significant differences between the counts of patients in different periods after platelet surgery and those before surgery in the two groups(P<0.05).Platelets in group A can maintain normal levels within one month(PLT>100×109/L),and platelets in group B can maintain normal levels within three months(PLT>100×109/L).The platelet level in group B was higher than that in group A at the 1st and 3rd month after surgery,with statistically significant difference(P<0.05).4.Complications and adverse reactions:Embolism syndrome was observed in both groups,and abdominal pain in the second and third days after operation was more severe in group A than in group B,with statistically significant difference(P<0.05).Other complications such as chest,ascites,fever,nausea and vomiting were not significantly different between the two groups.Conclusions:1.Quantitative embolization microspheres can obtain a more accurate spleen embolization volume.In clinical practice,the amount of embolization microspheres needed can be calculated according to the spleen volume before surgery to control the degree of spleen embolism2.Different sizes of 8spheres embolization microspheres can embolize different spleen volumes.The embolization volume of 500-700μm is smaller than that of 700-900μm microspheres,which should not cause recurrence of hypersplenism.There may be advantages in long-term efficacy.3.Quantitative embolization microspheres for PSE can avoid the inaccuracy of embolization volume evaluation caused by immediate postoperative angiography.4.8spheres embolization microspheres have good safety and effectiveness in PSE operation,which is worthy of further clinical application. |
PDF Full Text Request