Transcatheter arterial chemoembolization (TACE) combined with splenic embolization (PSE) is a commonly used therapeutic method for the treatment of primary hepatocellular carcinoma with hypersplenism, which can alleviate the reduction of WBC and PLT after chemotherapy, It can alleviate the reduction of WBC and PLT after chemotherapy and control the development of hepatocellular carcinoma, but the effect of the degree of splenic embolization on blood routine and some laboratory indexes of liver function has rarely been reported. The authors conducted a preliminary study on the effects of TACE combined with different ratios of PSE on blood routine and liver function in 45 patients with primary liver cancer and hypersplenism treated with TACE in our hospital from 2010/11 to 2012/11. 1, Materials and methods 1, 1 Clinical data Between November 2010 and November 2012, 45 patients with primary hepatocellular carcinoma with hypersplenism who underwent TACE combined with PSE were treated in our hospital. The preoperative and postoperative data were retained, and the preoperative liver function Child grading was A and B. According to the degree of PSE: the degree of splenic embolism was <50% for group A, and 50%~60% for group B. There were 21 cases in group A, 12 males and 9 females, aged 42~74 years old (56,5±8,74), and the diameter of the tumors was 5~12cm (8,24±2,64); 24 cases in group B, 14 males and 10 females, aged 44 years old (56,5±8,74); 24 cases in group B, 14 males and 10 females, aged 44 years old (8,24±2,64). Group B 24 cases, male 14 cases, female 10 cases, age 44-71 years (58,7±9,14), tumor diameter 4,5-12,2cm (8,50±2,44). 1,2 Treatment method TACE combined with PSE was performed, using modified Seldinger technique via femoral artery puncture path, selective contrast catheter for abdominal trunk arteriography to clarify intrahepatic lesions, splenic artery branches, and super-selected hepatocellular carcinoma blood-supplying arteries for conventional TACE; then catheter super-selected the distal part of the main trunk of the splenic artery or its splenic intra-splenic branches, avoiding the dorsal pancreatic artery and the gastrointestinal short arteries and embolization, according to the splenic According to the change of blood flow velocity in the main trunk of the splenic artery and the occlusion of the peripheral splenic artery branches seen on postembolization imaging, the splenic embolization material was 1mm diameter gelatin sponge particles + gentamicin 16mg + dexamethasone 10mg suspension. The degree of splenic embolization was <50% in group A and 50%~60% in group B. If splenic hyperfunction reappeared during the follow-up, PSE was performed again to supplement the embolic agent. Evaluation of the degree of splenic embolization: general embolization process when the blood flow rate slightly slowed down the degree of embolization is about 30-40%, the blood flow rate significantly slowed down the degree of embolization is about 50-60%, the contrast agent briefly stayed in the peristaltic advance embolization degree is about 70-80% [1]. 1, 3 Observation items Preoperative and postoperative 8 weeks weekly review of blood routine, record peripheral blood WBC, PLT, one week postoperative review of serum total bilirubin, alanine aminotransferase and glutamate turn, and Child grading. 1.4 Statistical analysis SPSS16.0 software should be used to perform t-test on the measurement data, and P<0.05 was considered statistically significant. 2.Results 2.1 Postoperative changes of WBC in peripheral blood of A and B groups WBC3.68±0.89×109/L in group A at 1 week after operation, then gradually increased and reached the peak at 5.87±0.78×109/L at 4 weeks after operation, then showed a persistent decline; WBC in group B at 1 week after operation was obviously increased and reached the peak at 7.43±054×109/L, and then gradually declined at 6.44±0.57×109/L。 0,57×109/L and stabilized. The results of postoperative review in each period showed that WBC in group B was significantly higher than that in group A. 2,2 The postoperative trend of PLT in peripheral blood of groups A and B was the same as the time of rechecking WBC counts, and the PLT counts in peripheral blood were measured, and the PLT counts of group A gradually increased to a peak value of 96,21±8,14×109/L in the 4th week, and then showed a decreasing trend; PLT of group B reached a peak value of 220±13,42×109/L in the 1st week postoperatively, and then a trend of decreasing; PLT of group B reached a peak value of 220±13,42×109/L in the 2nd week postoperatively, and then showed a trend of decreasing. and 42×109/L at 2 weeks postoperatively, and then stabilized after a slight decline, and the number of PLT in group B was significantly higher than that in group A in all periods. 2.3 Review of liver function at 1 week after operation Total bilirubin and alanine transferase and Child-Pugh score increased significantly in both groups, and then decreased slowly. 1 case of small amount of ascites appeared in group A patients after operation, which was considered as transient damage of liver function caused by TACE, and most of the patients in both groups recovered to the preoperative level in the postoperative review at one month after operation, and there was no significant difference in Child-Pugh score between the two groups of patients. 3.3.1 PSE treatment of primary liver disease in group B was significantly higher than that in group A. 3.1 The efficacy of PSE in treating primary hepatocellular carcinoma with hypersplenism For patients with primary hepatocellular carcinoma combined with hypersplenism, the clinical significance of actively treating hypersplenism lies in: 1) Reducing the phagocytosis effect of the spleen on the three lineages of cells; 2) Reducing the portal pressure and lowering the digestive mu mu m p p e c i a t i o n a l l a r t i c a t i o n s ÷ leftover; 3) Striving for a better therapeutic efficacy of TACE. In this paper, the short-term efficacy of both groups of patients were comparatively significant, and the postoperative WBC and PLT were significantly improved and maintained at normal levels. 3,2 The effect of different degrees of embolization on the efficacy In the treatment of TACE combined with PSE, there are fewer clinical studies on the effect of the degree of splenic embolization on the efficacy of the treatment.The study of Hayahsi[2] and others pointed out that the proportion of splenic embolization in patients with cirrhosis with hyper-splenism was positively correlated with the elevation of PLT in the postoperative period of 1 month, but there was no obvious correlation with the elevation of PLT in the long term. In the present study, the patients with primary liver cancer with portal hypertension and hypersplenism, group A showed a significant decreasing trend in the late follow-up period, and the long-term effect will be inferior to group B. This suggests that the proportion of splenic embolization is an important factor affecting the long-term efficacy of PSE, and the difference in the results of the two studies may be related to the difference in the selection of cases and the degree of embolization. In terms of the degree of embolization, the comprehensive opinion focuses on 40-70%, and other scholars believe that it is 50-70%. For splenic artery embolization in patients with hepatocellular carcinoma with hypersplenism, it should be 50-70% in order to achieve the above purpose. The study of Zhang Xinyuan [3] and other scholars showed that splenic embolization at 50%-60% resulted in a significant elevation of postoperative WBC and PLT, which tended to be stabilized after one month, and in the subsequent 5-year follow-up, WBC and PLT were stabilized at a level of about twice the preoperative level, which was similar to the results of the high percentage group in the present study, so that an appropriate increase in the percentage of splenic embolization can achieve better long-term efficacy. 3,3 Effects of different spleen embolization ratios on liver function TACE causes damage to liver function mainly from embolizing agents and chemotherapeutic drugs. There have been articles pointing out that the damage of TACE to liver function is greater than that of simple embolization in primary liver cancer is a special concern, TACE combined with PSE this treatment is no exception, at present, the effect of PSE on liver function is still very controversial at present, some studies have pointed out that after splenectomy disconnecting surgery, the portal blood flow is reduced by 28,6%, and the hepatic arterial blood flow is increased by 38,6%, which is conducive to the hepatic function recovery [4], and some scholars believe that PSE can likewise promote the recovery of liver function; Zheng Shan [5] and other scholars of the study pointed out that the TBL, ALT, AST of patients after PSE had no significant change with the number of before but the decrease of serum total bile acids was statistically significant, indicating that PSE is conducive to enhance the reserve capacity of liver function, and to reduce the extent of the damage to liver function caused by chemotherapeutic drugs and embolizing agents. In this study, there was no significant difference in liver function between groups with different degrees of splenic embolization, as seen in the 1-week postoperative follow-up, most of the liver function could be restored to the preoperative state, which may be related to the enhancement of patients' awareness of tumor prevention and treatment with the advancement of imaging equipment.Most of the patients' preoperative liver function in this study belonged to the patients with ChildA and B grades, with most of them in Grade A, so much so that the improvement of PSE on the liver function in the current The study did not show well, is also can show that ChildA, B grade patients TACE combined with PSE treatment is relatively safe, Hayahsi [6] also pointed out that Child classification of grade C is an important risk factor for complications of PSE surgery.