Treatment of radiofrequency ablation for cirrhotic hypersplenism
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摘要: 大部分肝硬化患者合并有脾功能亢进症,表现为脾脏肿大、一种或几种血细胞(主要是血小板、白细胞)减少。传统治疗措施存在较大的局限性和/或并发症。作者在国际上率先开展的脾脏射频消融治疗脾亢的新型微创措施,本文从脾脏射频消融治疗脾亢的工作原理、治疗入路、安全性、临床疗效、提高安全性和疗效的联合脾脏射频消融的多手段治疗模式等多个角度,总结了作者近10年的实验和临床实践经验。本文可为其他单位开展该项新技术提供一定的参考价值。Abstract: A large proportion of patients with liver cirrhosis complicated with hypersplenism, shows the sign of splenomegaly, anemia, thrombocytopenia, leucopenia, or pancytopenia.Conventional treatments have some limitations and complication.The authors firstly applied a minimally invasive procedure of radiofrequency ablation for hypersplenism used worldwide.The article reviewed the experimental and clinical experiences in radiofrequency ablation for hypersplenism in terms of principle, access, safety, efficacy, and RFA-based multimodalities strategy during recent 10 years.It may provide reference for others to develop a new technology.
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Key words:
- hypersplenism /
- liver cirrhosis /
- catheter ablation
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[1]Bashour FN, Teran JC, Mullen KD.Prevalence ofperipheral blood cytopenias (hypersplenism) in patientswith nonalcoholic chronic liver disease[J].Am JGastroenterol, 2000, 95 (10) :2936-2939. [2]刘全达, 何振平.肝硬化性脾亢的治疗进展和展望[J].现代实用医学, 2003, 15 (5) :273-276. [3]刘全达, 周宁新.肝硬化性脾功能亢进的外科治疗[J].局解手术学杂志, 2008, 17 (3) :149-150. [4]Caili A, Gara C.Complications of splenectomy[J].Am JMed, 121 (5) :371-375. [5]Okabayashi T, Hanazaki K.Overwhelmingpostsplenectomy infection syndrome in adults-Aclinically preventable disease[J].World J Gastroenterol, 2008, 14 (2) :176-179. [6]Koconis KG, Singh H, Soares G.Partial splenicembolization in the treatment of patients with portalhypertension:a review of the english language literature[J].J Vasc Interv Radiol, 2007, 18 (4) :463-481. [7]刘全达, 马宽生, 何振平, 等.射频消融治疗继发性脾肿大脾亢可行性和安全性的实验研究[J].中华外科杂志, 2003, 41 (4) :299-302. [8]Liu QD, Ma KS, He ZP, et al.An experimental study onthe feasibility and safety of radiofrequency ablation forsecondary splenomagely and hypersplenism[J].World JGastroenterol, 2003, 9 (4) :813-817. [9]刘全达, 马宽生, 何振平, 等.射频消融治疗门脉高压性脾功能亢进的临床研究[J].中华医学杂志, 2005, 85 (15) :1031-1034. [10]Liu Q, Ma K, He Z, et al.Radiofrequency ablation forhypersplenism in patients with liver cirrhosis:a pilot study[J].J Gastrointest Surg, 2005, 9 (5) :648-657. [11]Liu Q, Ma K, Song Y, et al.Two-year follow-up ofradiofrequency ablation for patients with cirrhotichypersplenism:Does increased hepatic arterial flowinduce liver regeneration?[J].Surgery, 2008, 143 (4) :509-518. [12]Peck-Radosavljevic M, Wichlas M, Zacherl J, etal.Thrombopoietin induces rapid resolution ofthrombocytopenia after orthotopic liver transplantationthrough increased platelet production[J].Blood, 2000, 95 (3) :795-801. [13]Cichoz-Lach H, Celiński K, Slomka M, et al.Pathophysiology of portal hypertension[J].J PhysiolPharmacol, 2008, 59 (Suppl 2) :231-238. [14]吴宇旋, 张彦舫, 郑雪芬, 等.经皮射频消融治疗脾功能亢进症[J].介人放射学杂志, 2009, 18 (5) :370-372. [15]刘全达, 周宁新, 王茂强, 等.肝脏移植术后脾动脉盗廊综合征的诊治[J].消化外科, 2004, 3 (4) :232-234. [16]刘全达, 周宁新, 王茂强, 等.肝移植术后脾动脉盗血综合征[J].中华外科杂志, 2005, 43 (15) :989-990. [17]李麟荪, 施海彬, 赵林波.肝移植术后并发症与介入治疗:三、肝移植术后动脉窃血综合征[J].介入放射学杂志, 2008, 17 (11) :764-768. [18]Nussler NC, Settmacher U, Haase R, et al.Diagnosis andtreatment of arterial steal syndromes in liver transplantrecipients[J].Liver Transpl, 2003, 9 (6) :596-602. [19]李晓勇, 刘新江, 周百中, 等.射频消融治疗脾功能亢进的临床研究[J].中原医刊, 2006, 33 (18) :21-22. [20]冯凯, 马宽生, 吴乔, 等.射频消融治疗脾功能亢进症对门静脉系统血流动力学的影响[J].消化外科, 2005, 4 (4) :261-264. [21]Rasekhi AR, Naderifar M, Bagheri MH, et al.Radiofrequency ablation of the spleen in patients withthalassemia intermedia:a pilot study[J].AJR Am JRoentgenol, 2009, 192 (5) :1425-1429.
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