摘要:目的 探讨肝动脉化疗栓塞术联合脾部分栓塞术治疗原发性肝癌伴脾功能亢进的临床应用价值。方法 确诊为原发性肝癌伴脾功能亢进患者60例，2013年10月至2014年6月就诊于解放军总医院第一附属医院介入科。60例患者被随机分配到A、B两组。A组为对照组，30例患者接受肝动脉化疗栓塞术；B组为实验组，30例患者接受肝动脉化疗栓塞术及脾部分栓塞术。治疗前后检测血常规、血凝四项、肝功能、T细胞亚群，免疫球蛋白及CT扫描。观察两组患者并发症的情况。结果 实验组患者术后外周血象、肝功能、凝血功能及免疫功能较术前有所改善，差异有统计学意义（P<0.05）；两组患者术后并发症间比较无显著地差异性（P<0.05），并未发生严重并发症。结论 肝动脉化疗栓塞术联合脾部分栓塞术是一种安全且有效的治疗方法，它能有效改善患者血细胞减少状况，改善肝功能，提高免疫力，且术后患者发生严重并发症的概率较低。
关键词：原发性肝癌；脾功能亢进；脾部分性栓塞术；肝动脉化疗栓塞术 

Abstract：Objective To investigate the clinical value of the liver artery chemotherapy and embolization combined with partial splenic embolization in the treatment of primary hepatocellular carcinoma with hypersplenism. Methods 60 cases of primary hepatocellular carcinoma with hypersplenism patients were randomly divided into two groups (30 patients in each group. Group A (control group) only received hepatic arterial chemoembolization and group B (experimental group) were received a basis of hepatic arterial chemoembolization combined with splenic partial embolization. The complete blood count，coagulation function, liver function, T cell subsets, immunoglobulin and CT scanning in all patients were tested before and after treatment. Complications were observed in two groups of patients. Results The postoperative peripheral blood, liver function, blood coagulation function and the preoperative immune function in experimental group patients were improved compared with that of before treatment (P < 0.05). There was no significant difference on postoperative complications between two groups of patients (P > 0.05). There was not serious complications occurred in both groups. Conclusion Hepatic artery chemotherapy embolization combined with partial splenic embolization could be an effective method to improve the patient’s blood cells, liver function and immunity with very low incidence of serious complications.