Efficacy of partial embolization of splenic artery in patients after hemorrhage of portal genesis

V. Petrushenko, D. Grebeniuk
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Abstract

Objective. To assess the efficacy of partial embolization of splenic artery in patients after hemorrhage of portal genesis. Materials and methods. Into the investigation 39 patients with verified diagnosis of hepatic cirrhosis, complicated by portal hypertension and hemorrhage from widened varicose esophageal veins, were included. Into the first group (n=17) were included the patients, to whom endoscopic ligature of bleeding varicosities and partial embolization of splenic artery performed; into the second one (n=22) - patients, to whom independent endoscopic ligature of bleeding varicosities performed. The levels of laboratory indices, characterizing hepatic functional state, were assessed monthly. Results. In the first group upon a time a progressive statistically significant improvement of all indices investigated was noted. In the second group a statistically significant improvement of all indices was observed in a period between first and second visit. In further times the changes did not have a statistical significance. While conduction of multifactorial analysis of variance for investigation of embolia impact on the pigmentary metabolism and the system of hemostasis indices a trustworthiness of this impact had grown up upon a time and on the fourth visist became statistically significant. While investigation of the embolization impact on the level of hepatic enzymes and the proteins metabolism indices the trustworthiness of the dependence have been grown upon a time as well, but its gaining of statistical significance was observed on the third visit already. Conclusion. Postoperative period after performance of partial embolization of splenic artery in patients, suffering hemorrhage of portal genesis, is characterized by positive dynamics of laboratory indices in hepatic functional state.
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脾动脉部分栓塞治疗门静脉源性出血的疗效观察
目标。目的探讨脾动脉局部栓塞治疗门静脉源性出血的疗效。材料和方法。本研究纳入39例确诊为肝硬化合并门脉高压及食管静脉曲张增宽出血的患者。第一组(17例)采用内窥镜结扎出血性静脉曲张及脾动脉部分栓塞术;进入第二组(n=22) -患者,对其进行独立的内镜结扎出血静脉曲张。每月评估表征肝功能状态的实验室指标水平。结果。在第一组中,在一段时间内,所有调查的指标都有统计学上的显著改善。在第二组中,在第一次和第二次访问之间的一段时间内观察到所有指标的统计学显着改善。在以后的时间里,这些变化没有统计学意义。在进行多因素方差分析以调查栓塞对色素代谢和止血系统指标的影响时,这种影响的可信度在一段时间内增长,在第四次访问时具有统计学意义。栓塞对肝酶水平和蛋白质代谢指标影响的调查也随着时间的推移而增加,但在第三次访问时已经观察到其获得统计学意义。结论。门静脉源性出血患者行脾动脉部分栓塞术后,肝功能状态实验室指标动态呈阳性。
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