1 left upper abdominal pain
Left epigastric pain is a common complication after splenic embolization. The symptoms are unbearable pain in the left upper abdomen, which can radiate to the left shoulder. It is characterized by swelling pain, tingling, tapping pain, refusal to press, dark red tongue, white or yellow greasy fur and thready pulse. Color Doppler ultrasound showed splenomegaly and blood stasis. Peripheral blood picture shows that platelets rise rapidly and individual platelets aggregate. Syndrome differentiation in traditional Chinese medicine is mostly qi stagnation and blood stasis, and blood stasis blocks collaterals. The treatment is mainly to promote qi circulation and relieve pain. Rhizoma corydalis, Radix Notoginseng, Cortex Ilicis Rotundae, Dwarf Tea, Fructus Toosendan, etc. In addition, lappaconitine injection or aconite injection was injected intravenously/kloc-0 once a day for 1 ~ 2 weeks. Using traditional Chinese medicine or traditional Chinese medicine preparation for abdominal pain after splenic embolization can reduce the damage of western sedatives to liver function and is beneficial to the postoperative rehabilitation of patients.
2 fever
After splenic embolization, most patients have fever and chills due to the reaction of splenic parenchymal infarction. Fever usually occurs at 38 ~ 39℃, sometimes reaching above 39℃, lasting for about 2 ~ 3 weeks, accompanied by dry mouth, alcoholism, irritability and sweating, dry stool, short and red urine, red tongue with yellow fur, and strong or slippery pulse. TCM syndrome differentiation is Yangming excess heat syndrome. It is advisable to clear away heat and detoxify. Radix Rehmanniae, Cortex Moutan, Radix Paeoniae Rubra, Flos Lonicerae, Folium Isatidis, Herba Houttuyniae, Rhizoma Phragmitis, Herba Nerviliae, etc. In addition, Houttuynia cordata injection or Qingkailing injection can be used for intravenous drip to avoid the burden of antibiotics on liver and kidney.
3 liver function damage
Transient liver damage may occur in early patients after splenic embolization, especially in patients with liver cirrhosis. After splenic embolization, transaminase may increase sharply, and even jaundice may worsen progressively. The symptoms are anorexia, fatigue, aversion to oil, yellow urine, yellow eyes, dark red tongue, yellow or white greasy fur and slippery pulse. Laboratory examination showed that ALT and AST increased moderately. The increase of total bilirubin, especially direct bilirubin, suggests cholestatic jaundice. TCM syndrome differentiation is that the liver and gallbladder are damp and hot, and the blood stasis and heat are intertwined. It is advisable to clear the liver and benefit the gallbladder, remove jaundice and cool blood, and promote blood circulation and remove blood stasis. Yinchenhao decoction is often used for addition and subtraction, and it is used for medicinal raw rhubarb, Herba Artemisiae Scopariae, Fructus Gardeniae, Radix Gentianae, Radix Asteris Mantidis, Herba Hyperici Japonici, Herba Houttuyniae, Herba Hedyotidis Diffusae, Herba Patriniae and Radix Paeoniae. Compound glycyrrhizin injection 160mg or Ganlixin injection 30ml and Yinzhihuang injection 30 ~ 50 ml were diluted respectively, then intravenous drip, and intramuscular injection of GanLing Ye or Ganyanling injection 4ml 1 time/day, with a course of treatment of 2 ~ 4 weeks. After traditional Chinese medicine treatment, the diet is light, attention is paid to rest, transaminase recovers quickly, jaundice subsides, and the postoperative rehabilitation time is greatly shortened.
4 digestive tract symptoms
After splenic embolization, spleen infarction reaction, gastrointestinal tract and diaphragm are stimulated, and a series of digestive tract symptoms such as abdominal distension, belching, nausea, vomiting, hiccup, anorexia, dry mouth and bitter taste, reddish tongue, thin yellow and greasy fur and slippery pulse will appear. Syndrome differentiation of traditional Chinese medicine is that the liver and stomach are depressed with heat, and the stomach qi is flushed upward, so it is advisable to clear away heat and promote diuresis and the stomach qi is flushed downward.
5. Left lower pneumonia, left pleural effusion and atelectasis
After splenic embolization, splenic infarction and capsular tension stimulate pleura and restrict respiratory movement, resulting in poor bronchial drainage complicated with left lower pneumonia, pleural effusion and atelectasis. Symptoms are chest pain, chest tightness, shortness of breath, cough, chest pain is obvious when inhaling, even shortness of breath, yellow phlegm, thick blood, dyspnea, red tongue, Huang Gan fur and slippery pulse. Laboratory tests showed an increase in white blood cells. Most of them are phlegm-heat blocking the lungs, and the treatment should be mainly to clear away heat, purge the lungs and relieve asthma. Commonly used Maxingshi dry soup and granule jujube Xie Fei soup, as well as ephedra, gypsum, buffalo horn, almond, lepidium, jujube, houttuynia cordata, orange stem, Trichosanthes kirilowii, Peucedanum, Fritillaria thunbergii and so on. They are all used to treat diseases. Clinical symptoms are easily relieved, inflammation is absorbed, and pleural effusion subsides. For patients with atelectasis, Xiangdan injection can be diluted to 20 ~ 40 ml and then given intravenously, once a day, 1 course of treatment for two weeks, 1 ~ 2 course of treatment 1 time.
In addition, for other complications after splenic embolization, such as splenic liquefied necrotizing abscess, splenic portal vein thrombosis, acute pancreatitis and so on. Syndrome differentiation and treatment of TCM can also achieve good curative effect, which needs to be further accumulated and summarized in the future so that TCM can play its unique role in this field.