Application Of Different Embolic Materials In Partial Splenic Artery Embolization

Objective:To explore the safety and effectiveness of different embolic materials of the different embolic materials in patients with hypersplenic cirrhosis(hypersplenism)undergoing partial splenic artery embolization(PSE),and to seek a more safe and effective method for patients with hypersplenic cirrhosis undergoing partial splenic artery embolization.Methods:Retrospective analysis was performed on 60 patients with hypersplenism due to cirrhosis,including 20 patients with embolization using 560～710 μm gelatin sponge embolization particles,20 patients with embolization using 300～500 μm embolization microsphere embolization,and 20 patients with embolization using 500～700 μm embolization microsphere embolization,including group A,group B and group C.Changes of peripheral blood white blood cells and platelet count before and after operation on day 3,day 7,month 1,month 3 and month 6,as well as postoperative fever and pain were observed.The safety and effectiveness of different embolic materials during partial splenic artery embolization in patients with hypersplenism due to cirrhosis were compared between group A and group C.Comparative analysis was performed between group B and group C to compare the safety and effectiveness of partial splenic artery embolization in patients with hypersplenism due to cirrhosis.Results:1.Changes in peripheral blood cells:white blood cells at 3 days,7 days before and after surgery(×109/L):Group A:2.05±0.71,7.95±1.43,6.23±0.98,3.71±0.85,2.98±0.45,and group B:2.10±0.58,7.81±1.78,6.56±0.83,5.22±0.68,5.19±0.72,and group C:1.91±0.66,8.02±2.52,6.11±1.65,5.34±0.73,5.27±1.12.Peripheral blood platelet count(×109/L):Group A was 37.05±12.53,80.01 ± 13.27,139.55±59.87,154.21±40.32,101.23± 15.37,85.69±19.57,and group B was 42.60±18.61,78.30±18.76,135.65±63.23,155.35±28.05,140.31±21.34,respectively.Groups C were 33.30±11.41,76.30±14.60,144.95±62.75,158.50±42.04,144.45±26.74,139.78±20.11,respectively.The comparison between group A and group C showed that platelet and leukocyte counts at 3 and 7 days and 1 month after PSE were significantly higher than that before PSE(p<0.001),and there was no significant difference between the two groups(p>0.05).However,platelet and leukocyte count in group A began to decline 3 months after surgery,while platelet and leukocyte count in group C remained stable,with differences between the two groups(p<0.05).Comparison between group B and group C showed that platelet and leukocyte counts at 3 and 7 days,and 1,3 and 6 months after PSE were significantly higher than that before PSE(p<0.001),and there was no significant difference between the two groups(p>0.05).2.PSE postoperative complications:the incidence of postoperative fever and pain in group A and degree are:low thermal heat in 5 cases(25%),12 cases(60%),fever(3 cases),pain(15%),0 0 cases,7 cases(35%),the degree of pain Ⅰ,Ⅱ degree of pain in 11 cases(55%),III degree of pain,2 cases(10%),the incidence of postoperative fever and pain in group B and degree are:Low thermal heat in 15 cases(75%),4 cases(20%),high heat in 1 case(5%),2 cases(10%)0 degrees of pain,pain I degree of 16 cases(80%),the degree of pain in 2 cases(10%)Ⅱ,Ⅲ degree of pain 0 cases,the incidence of postoperative fever and pain in group C and degree are:low thermal heat in 6 cases(30%),11 cases(55%),fever(3 cases),pain(15%),0 0 cases,8 cases(40%),the degree of pain Ⅰ,Ⅱ,pain pain in 9 cases(45%),Ⅲ degree in 3 patients(15%).After the comparison between group A and group C,the incidence and degree of postoperative fever and pain in group C were significantly reduced compared with group A(p<0.05).After the comparison between group B and group C,the incidence and degree of postoperative fever and pain in group B were significantly reduced compared with group C(p<0.05).Conclusions:1.As embolic material PSE,the gelatin sponge embolism particles with Embosphere ball all can obtain the better curative effect in the short term,but with the extension of patients with postoperative follow-up time,the use of gelatin sponge embolism particles embolization in patients with curative effect began to decline,peripheral blood cell count began to decline,while use Embosphere particle ball curative effect of patients remain at a stable level.2.There is no significant difference between the efficacy of the particles with diameter of 300～500μm and that of the particles with diameter of 500～700 μm in the embolization materials of embolization of PSE with different particle sizes.