目的 探讨体外高强度聚焦超声治疗(HIFU))脾功能亢进的安全性、可行性和近期疗效.方法 在超声引导下对18例门脉高压性脾功能亢进患者进行HIFU治疗,治疗区域为脾脏中下及周围区,单次治疗时间平均为(29.4±8.6)min,平均治疗次数为(16±7.1)次,定期观察外周血象及超声检查变化.结果 与治疗前比较白细胞和血小板显著升高(P＜0.01),红细胞无明显变化.治疗后发热l例,局部皮肤潮红1例.B超检查脾脏治疗区域回声明显增强.随访三个月,门静脉及脾静脉内径无明显变化.结论 脾脏高强度聚焦超声治疗是治疗门脉高压性脾功能亢进安全的微创方法,近期疗效显著,可作为治疗脾亢的一种新的微创治疗方法.%Objective To investigate the safety, feasibility and recent efficacy of high intensity focused ultrasound(HIFU) in ablation of hypersplenism. Methods Eighteen patients with hypersplenism were treated by HIFU under ultrasound guidance, Peripheral area of the middle and lower part of spleen were treated with HIFU. Each patient was treated for (16±7.1) times and each treatment took (29.4±8)6min on average. The peripheral blood cell counts and changes of spleen were measured regularly. Results After the HIFU treatment, the counts of WBC and PIT increased gradually, and are significantly high than those before H1FU(P <0.01). There were no significant change hi RBC counts before and after treatment One case developed fever and another case developed light skin burn. Coagulative necrosis was observed in all patients immediately after treatment. Ultrasonic examination showed significant increase of echo in the area treated. 3-month follow-up showed no significant changes in the diameter of the portal vein and splenic vein compared with those before treatment. Conclusion Treatment by high intensity focused ultrasound (HIFU) is a safe, minimally-invasive approach for the management of hypersplenism caused by portal hypertension. The recent effect of HIFU is remarkable; therefore, HIFU treatment may be a new effective and minimally invasive method for ablation of hypersplenism.
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