探讨部分脾动脉栓塞术（PSE）治疗儿童遗传性球形红细胞增多症（HS）的临床疗效。

选取2000—2015年入住我院的儿童HS患者38例，采用Seldinger技术，以150~350 μm明胶海绵微粒行PSE术。比较PSE前后的临床表现、外周血象的缓解情况、脾脏的缩小情况、肝功能改善情况、免疫功能的变化。

38例术后1、3、6个月、1、3、5年随访脾脏均有不同程度的缩小，33例完全缓解，4例部分缓解，l例副脾形成。患儿发育及营养状况较术前明显改善。血红蛋白（Hb）和红细胞均明显回升。肝功能恢复正常，胆色素降至正常未再升高（均P<0.01）。血清免疫球蛋白水平与治疗前相比差异无统计学意义（P>0.05）。1例早期病例术后出现脾脓肿，对症治疗后好转，所有病例均未出现脾静脉血栓形成、下肢动静脉血栓形成及脾破裂等严重并发症。

PSE治疗儿童HS的临床效果明显，创伤小，并发症少。既达到与切脾相似的疗效，又具有保留脾脏免疫功能的优点，PSE是首选治疗儿童HS的方法，值得临床推广应用。

To assess the clinical therapeutic effect of partial splenic artery embolization (PSE) in the treatment of hereditary spherocytosis (HS) in children.

A total of 38 children suffering from HS received PSE in our hospital from 2000 to 2015 were selected and treated by PSE, using Seldinger technique and 150~350 μm gelatin sponge particles. The clinical manifestations, peripheral blood picture, spleen contraction, liver function improvement and immune function were compared before and after PSE.

In all 38 cases, spleen was reduced to a certain extent in the follow-up visits in 1, 3, 6 months and 1, 3, 5 years. In 33 cases complete response was achieved, and in 4 cases partial response was achieved. In 1 case, an accessory spleen was formed. After the operation, the patients’s development and nutritional status were improved significantly. Notable recovery could be observed both in hemoglobin (Hb) and red blood cells. Liver function returned to normal. Unconjugated bilirubin decreased to normal with no rise. The difference of serum immunoglobulin levels 1~3 years after the operation was not statistically significant (P>0.05) . One early case encountered splenic abscess after operation and recovery was achieved after receiving treatment based on symptoms. There was no occurrence of serious complications such as splenic vein thrombosis, lower extremity arteriovenous thrombosis, splenic rupture and so on in all 38 cases.

PSE has obvious effect in treating HS in children, with minimal operative wound and few complication. It can not only achieve similar effect as splenectomy, but also enjoy the advantage of preserving the immune function of spleen, PSE, as the preferred method to treat HS in children, is worthy of clinical application and promotion.