不同脾动脉栓塞术式治疗乙型病毒性肝炎肝硬化脾功能亢进的临床疗效对比研究

doi:10.19871/j.cnki.xfcrbzz.2026.03.003

新发传染病电子杂志 ›› 2026, Vol. 11 ›› Issue (3): 13-18.doi: 10.19871/j.cnki.xfcrbzz.2026.03.003

不同脾动脉栓塞术式治疗乙型病毒性肝炎肝硬化脾功能亢进的临床疗效对比研究

刘文浩¹, 周昀², 肖亮¹, 康志龙³, 黄湘荣¹, 王明波¹, 冯凯¹, 杨根东², 黄华²

1.深圳市第三人民医院/南方科技大学第二附属医院放射介入科,广东深圳 518112;
2.深圳市第三人民医院/南方科技大学第二附属医院放射科,广东深圳 518112;
3.深圳市第三人民医院/南方科技大学第二附属医院肝胆外科,广东深圳 518112

收稿日期:2026-01-01 出版日期:2026-06-30 发布日期:2026-07-17
通讯作者: 黄华,Email:hncz05hh@163.com
基金资助:
1.深圳市卫生健康菁英人才项目;2.深圳市高水平医院建设专项（2022108）

A comparative study on the clinical efficacy of different splenic artery embolization procedures in the treatment of hypersplenism in patients with hepatitis B liver cirrhosis

Liu Wenhao¹, Zhou Yun², Xiao Liang¹, Kang Zhilong³, Huang Xiangrong¹, Wang Mingbo¹, Feng Kai¹, Yang Gendong², Huang Hua²

1. Department of Interventional Radiology, Shenzhen Third People's Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Guangdong Shenzhen 518112, China;
2. Department of Radiology, Shenzhen Third People's Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Guangdong Shenzhen 518112, China;
3. Department of Hepatobiliary Surgery, Shenzhen Third People's Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Guangdong Shenzhen 518112, China

Received:2026-01-01 Online:2026-06-30 Published:2026-07-17

摘要/Abstract

摘要： 目的对比研究部分脾动脉栓塞术、脾动脉主干栓塞术以及脾动脉主干栓塞联合部分脾动脉栓塞术治疗乙型病毒性肝炎肝硬化脾功能亢进的临床疗效,为选择更有效治疗脾功能亢进的介入治疗方式提供依据。方法回顾性分析2023年1月至2025年4月在深圳市第三人民医院接受介入放射栓塞治疗的85例乙型病毒性肝炎肝硬化导致脾功能亢进患者的临床资料,根据介入放射栓塞治疗术式的不同分为三组,A组22例,行部分脾动脉栓塞术;B组33例,行脾动脉主干栓塞术;C组30例,行部分脾动脉栓塞联合脾动脉主干栓塞术。比较三组的手术成功率、术后不同时间段外周血三系细胞计数变化以及手术相关不良反应发生情况。结果 3种术式的手术成功率均为100%。术后1个月,三组患者白细胞及血小板计数均较术前显著升高（P<0.05）,其中C组血小板计数升高程度高于A组及B组（P< 0.05）。术后2个月复查,A组白细胞计数仍显著高于术前（P<0.05）,C组红细胞及血小板计数仍显著高于术前（P<0.05）。此外,B组与C组术后脾动脉闭塞发生率均显著高于A组（P<0.05）。结论 3种介入放射栓塞治疗术式均可短期改善脾功能亢进所致的血小板、白细胞计数降低,其中脾动脉主干栓塞联合部分脾动脉栓塞术对提升并维持血小板计数效果更好。

关键词: 乙型病毒性肝炎, 肝硬化, 脾功能亢进, 部分脾动脉栓塞术, 脾动脉主干栓塞术, 介入放射栓塞治疗

Abstract: Objective To compare the clinical efficacy of partial splenic embolization (PSE), main splenic artery embolization (MSAE), and combined MSAE plus PSE in the treatment of hypersplenism secondary to hepatitis B-related cirrhosis, so as to provide evidence for optimizing interventional strategies for hypersplenism. Method A retrospective analysis was performed on 85 patients with hepatitis B cirrhotic hypersplenism who received interventional embolization therapy in Shenzhen Third People's Hospital from January 2023 to April 2025. Patients were divided into three groups according to different surgical procedures: group A (n=22) underwent PSE alone, group B (n=33) underwent MSAE alone, and group C (n=30) underwent combined MSAE and PSE. The operative success rate, dynamic changes in peripheral blood three-line cell counts at different postoperative time points, and incidence of procedure-related adverse reactions were compared among the three groups. Result The operative success rate was 100% in all three groups. At 1 month postoperatively, white blood cell and platelet counts in all three groups were significantly higher than preoperative levels (P<0.05), and the elevation magnitude of platelet count in group C was significantly greater than that in group A and group B (P<0.05). At 2-month follow-up, white blood cell count in group A remained significantly higher than baseline (P<0.05), while red blood cell and platelet counts in group C remained significantly elevated compared with preoperative levels (P<0.05). In addition, the incidence of postoperative splenic artery occlusion in group B and group C was significantly higher than that in group A (P<0.05). Conclusion All three interventional embolization procedures can effectively improve thrombocytopenia and leukopenia induced by hypersplenism in the short term. Conclusion All three interventional embolization procedures can effectively improve thrombocytopenia and leukopenia induced by hypersplenism in the short term. Combined MSAE plus PSE achieves superior efficacy in elevating and maintaining platelet counts.

Key words: Viral hepatitis type B, Liver cirrhosis, Hypersplenism, Partial splenic embolization, Main splenic artery embolization, Interventional radiological embolization therapy

中图分类号:

刘文浩, 周昀, 肖亮, 康志龙, 黄湘荣, 王明波, 冯凯, 杨根东, 黄华. 不同脾动脉栓塞术式治疗乙型病毒性肝炎肝硬化脾功能亢进的临床疗效对比研究[J]. 新发传染病电子杂志, 2026, 11(3): 13-18.

Liu Wenhao, Zhou Yun, Xiao Liang, Kang Zhilong, Huang Xiangrong, Wang Mingbo, Feng Kai, Yang Gendong, Huang Hua. A comparative study on the clinical efficacy of different splenic artery embolization procedures in the treatment of hypersplenism in patients with hepatitis B liver cirrhosis[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(3): 13-18.

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不同脾动脉栓塞术式治疗乙型病毒性肝炎肝硬化脾功能亢进的临床疗效对比研究

A comparative study on the clinical efficacy of different splenic artery embolization procedures in the treatment of hypersplenism in patients with hepatitis B liver cirrhosis

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