Purpose: To study the value of partial splenic embolization (PSE) for the treatment of hypersplenism in patients undergoing embolization of hepatocellular carcinoma (HCC). Methods: Transcatheter hepatic arterial embolization (THAE) combined with PSE was performed in 30 patients with HCC complicating liver cirrhosis, portal hypertension, and hypersplenism. Gelfoam sponge was used as the embolic material for PSE and limited to 100-150 pieces. Results: More than 50% of splenic parenchyma was infarcted in 27 patients. Leukopenia and thrombocytopenia were corrected by PSE in 25 of 27 patients with hypersplenism. In 26 patients with esophageal varices, including 5 patients with bleeding, no rebleeding occurred during a 6-17 month follow-up. Hypersplenism was not corrected in 2 of 3 patients whose infarcted splenic parenchyma was less than 50%. No splenic abscesses or other severe complications were observed. Of the 30 patients treated, 19 are still alive after 1 year. Conclusions: THAE combined with PSE is a safe and effective measure for patients with HCC.

目的：探讨部分性脾栓塞（PSE）在肝癌介入治疗中的意义和方法。材料与方法：采用肝动脉化疗栓塞术（THAE）和PSE并用的方法治疗30例合并肝硬化、门脉高压和脾功能亢进的肝癌患者。将PSE的栓塞材料明胶海绵限制在160粒以内以防止过量栓塞。结果：27例脾栓塞面积在50%以上；25例脾功能亢进缓解；26例食管静脉曲张包括6例有消化道出血者，5例于PSE后1年之内未再发生出血；未发生脾脓肿等严重并发症。3例脾栓塞面积在50%以下的患者中2例脾功能亢进未缓解。结论：PSE与THAE并用是治疗肝癌合并肝硬化、门脉高压和脾功能亢进的安全、有效的方法。栓 塞剂定量的方法有助于避免脾的过量栓塞，减少并发症。

目的 评价肝动脉造影CT扫描（CTHA）和动脉性门脉造影CT扫描（CTAP）在肝癌介入治疗中的应用价值和意义。方法 12例接受重复肝动脉化疗栓塞治疗的肝癌患者，利用双导管技术同时进行了CTAP和CTHA检查。结果 CTAP和CTHA发现29个直径小于10mm的新病灶；CTAP明确显示了栓塞后肿瘤周边部的不同改变；CTHA显示了病灶的血供状况，提示了侧支供血、描绘出肝硬化结节的形态学改变及其演变过程中血供来源的变化。结论 肝癌介入治疗中的CTAP和CTHA检查具有重要的价值和意义。它能为介入治疗提供诸多有用的信息，指导介入治疗的实施。