| Objective: To investigate clinical effects of curing hypersplenism complicated by hepatic cirrhosis using fractional and dispersal splenic artery embolization,and to explore new methods for patients whose is receiving splenic artery embolization therapy.Methods: Collected the medical information of the 41 patients who received parital splenic artery embolization therapy to cure hypersplenism complicated by hepatic cirrhosis in The Affiliated Hospital of Zunyi Medical University from June 1st,2012 to December 31 st,2014. All the samples was be divided into Group A and Group B according to the time they received therapy: patients who received the one-time concentrated and flaked splenic artery embolization therapy before October 1st, 2013 are put into Group A, totaling 25; and patients who received fractional and dispersal splenic artery embolization therapy after October 1st, 2013 are positioned into Group B, totaling 16. Patients in Group B were given the second embolism therapy within two months after the first one. Observation is recorded from the time after the first operation. The observation indicates: count of peripheral blood cell(WBC、RBC、PLT) and liver function Child-pugh scores one week, two weeks, one month, two months, three months, four months and five months respectively after the operation, and incidence rate of abdominal pain, abdominal pain VAS scores and duration, incidence rate of complication and accumulated hospitalization time after the operation. Measurement data is expressed as x ±s and statistic analysis is carried out on relevant indicators with SPSS 17.0 software.Results:1.Changes of peripheral blood cells : WBC counts(×109/L)before the operation, postoperation one week, two weeks, one month, two months, three months, four and five months respectively were:2.07±0.46, 9.10±1.79, 7.20±1.12, 6.63±1.05, 5.98±0.69, 5.12±0.65, 4.83±0.56, 4.58±0.49 in group A, the counts in group B respectively were:2.14±0.67, 6.41±1.76, 5.75±1.40, 4.65±0.58, 7.38±1.56, 5.49±1.04, 4.94±0.69,4.67±0.48.RBC counts(×1012/L) in group A respectively were:3.83±0.38, 3.78±0.35, 3.81±0.36, 3.85±0.40, 3.82±0.34, 3.95±0.32, 4.05±0.62, 4.13±0.42, RBC counts in group B respectively were: 3.96±0.58, 3.95±1.25, 3.99±1.33, 4.03±1.52, 4.02±1.41, 4.15±1.62, 4.37±1.58, 5.35±1.37.PLT counts(×109/L)in group A respectively were: 25.64±8.89, 92.56±23.43, 84.20±16.82, 75.88±14.47, 67.68±8.79, 62.92±6.47, 59.16±5.84, 55.68±5.80, PLT counts in group B respectively were:29.44±10.00, 54.38±9.24, 69.06±6.91, 62.06±6.22, 74.75±10.65, 84.94±19.23, 68.38±12.67, 63.56±6.44. The WBC, PLT counts in the observation period after the operation are both higher than the counts before the operation, and p value is 0.000, the difference has statistical significance. The RBC counts after the operation four and five months in group A are higher than the ones before the operation, the RBC counts after three months, four and five months in group B are also higher than the counts before the operation, the number p is less than 0.05, the difference has statistical significance. But comparing the RBC counts in other time period in two groups, the difference has no statistical significance. The WBC counts in group A after the operation one week, two weeks and one month are respectively higher than the ones in group B, the number p is less than 0.05, which shows the difference has statistical significance. The WBC counts in group A after two months, three months, four months and five months are less than the ones in group B, wherein with comparing the counts after two months and three months, it can be found that p<0.05, the difference has statistical significance, but comparing the counts after 4 months and 5 months, it is found that p>0.05, which has no statistical significance. The PLT counts in the observation period after 1 week, 2 week and 1 month in group A are higher than group B, and p<0.05, which has statistical significance. The PLT counts in group A after 2 months, 3 months, 4 months and 5 months are less than the ones in group B, and p<0.05, the difference has statistical significance. Comparing the RBC counts in the same observation period between group A and B, the numbers P are all higher than 0.05, the difference has no statistical significance.2.Child-pugh scores of liver function: the scores in group A after one week, two week, one month and two months respectively were: 10.08±1.70, 10.20±1.47, 9.40±1.19, 7.40±1.78, which are higher than the score 5.84±0.85 before the operation, p value is 0.000, the difference has statistical significance. The scores after three months, four and five months after operation respectively were: 6.27±0.96, 6.72±1.15, 6.60±1.12, comparing to thescores before the operation, the difference has no statistical significance. The scores after one week and two weeks after operation respectively were: 8.69±1.74, 7.68±0.87, which are higher than the score 5.75±0.68, and p value is 0.000, the difference has statistical significance.The scores after one month, two months, three months, four and five months respectively were: 6.06±0.77, 6.13±0.89, 6.25±0.93, 6.09±0.91, 6.54±0.96, comparing to the scores before the operation, the difference has no statistical significance. The scores in group A after one week, two weeks, one month and two months are higher than the ones in group B, p<0.05, which shows statistical significance. Comparing the scores after three months, four months and five months after operation, it is found that p>0.05, the difference has no statistical significance.3. Complications after the PSE operation: the incidence rate of abdominal pain, abdominal pain VAS scores and the duration in group A respectively were 92%(23/25),(58.76±30.14),(9.45±6.25)days; the ones in group B respectively were 50%(8/16),(25.49±18.76),(3.20±3.15)days, the numbers in group A are higher than the ones in group B, the numbers P are all less than 0.05, it’s has statistical significance. Postoperation complication: the numbers of patients getting the malignant ascites, pleural reaction and splenic abscess in group A respectively were 18(72%), 16(64%) and 4(16%), the number sin group B respectively were 3(18.75%), 4(25%) and 0, the incidence rate in group A is higher the ones in group B.4. The cumulative length of hospital stay for the sequential treatment after PSE operation:(17.45±7.25) days in group A,(10.12±3.35)days in group B, the length in group A is higher than the one in group B, and p<0.05, the difference has statistical significance.Conclusion: The fractional and dispersal splenic artery embolization therapy curing the hypersplenism complicated by hepatic cirrhosis is better than the one-time concentrated and flaked embolize method, the condition of peripheral blood cell is proved after the PSE operation, the effect to the liver function is relatively slighter, the incidence rate of the complication is lower and the cumulative length of hospital stay is relatively shorter. |
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