论文部分内容阅读
目的初步探讨超声引导下冷循环微波消融治疗肝硬化脾肿大、脾功能亢进的临床疗效。方法选择38例肝硬化伴有脾增大、脾功能亢进患者,超声引导下对脾组织行经皮微波消融,术后即刻行超声造影观察消融范围,分别于治疗前及术后1周、1、3、6、12、24个月检测患者外周血常规观察白细胞、血小板变化;术后观察患者并发症发生情况。结果消融治疗后外周血白细胞、血小板1周开始升高,到1个月白细胞、血小板明显升高,与治疗前相比差异有统计学意义(P<0.05)。升高持续3、6、12个月分别为17、12、5例,24个月仍较术前明显升高4例。超声造影观察微波消融范围越大,白细胞、血小板计数越高。术后出现并发症12例,无严重并发症发生。结论超声引导经皮冷循环微波消融作为一种微创方法治疗继发性脾增大、脾功能亢进,短期内疗效确切,并发症少,患者术后恢复快,具有重要的临床应用价值。
Objective To investigate the clinical effect of microwave-assisted microwave ablation guided by ultrasound in the treatment of cirrhosis and splenomegaly and hypersplenism. Methods Thirty-eight patients with cirrhosis accompanied with splenomegaly and hypersplenism were selected. Percutaneous microwave ablation was performed on the spleen tissue guided by ultrasound. The scope of ablation was observed by ultrasound contrast immediately after the operation. Peripheral blood leukocytes and platelets were detected at 3, 6, 12, and 24 months after operation. Postoperative complications were observed. Results After the treatment of peripheral blood leucocytes and platelets, the level of white blood cells and platelets began to increase at 1 week. By 1 month, the number of white blood cells and platelets increased significantly, which was significantly different from that before treatment (P <0.05). Elevated for 3,6,12 months were 17,12,5 cases, 24 months still significantly higher than the preoperative 4 cases. Contrast ultrasound observation The greater the scope of microwave ablation, white blood cells, the higher the platelet count. Postoperative complications occurred in 12 cases, no serious complications. Conclusion Ultrasound-guided percutaneous microwave ablation as a minimally invasive method for the treatment of secondary splenomegaly and hypersplenism, the short-term curative effect is accurate, less complications, the patient recovered quickly, has important clinical value.