门静脉高压症合并脾功能亢进常导致严重并发症，传统脾切除术具有自身的局限性。本文从外科视角系统探讨脾动脉部分栓塞术（PSE）治疗该病的理论基础、精准实践策略及其与其他治疗手段的协同应用。PSE通过栓塞脾动脉远端分支减少脾脏血流，从而有效降低门静脉压力、纠正血细胞减少、缓解脾脏盗血现象、改善肝脏灌注，同时保留一定的免疫功能。其精准实践包括术前CT血管成像及三维体积评估以指导决策、术中采用选择性或非选择性栓塞策略、多材料组合应用以优化效果，以及术后针对性管理以预防栓塞后综合征、脾脓肿和门静脉血栓等并发症。PSE与脾切除术、经颈静脉肝内门体分流术（TIPS）、经导管动脉化疗栓塞术（TACE）及肝移植等联合应用，可作为术前预处理、桥接治疗或联合方案。总之，PSE是一种安全、微创、有效的治疗手段，已成为门静脉高压症合并脾功能亢进多模态治疗的核心组成部分。未来借助新型材料、人工智能及精准影像技术，其疗效将进一步提升，外科医师应积极融入多学科协作，制定个体化策略以优化患者长期预后。

Portal hypertension complicated with hypersplenism often leads to severe complications, while traditional splenectomy has its own limitations. From a surgical perspective, this article systematically explores the theoretical basis, precise practice strategies, and synergistic applications of partial splenic artery embolization (PSE) with other treatment modalities in managing this condition. PSE reduces splenic blood flow by embolizing distal splenic artery branches, thereby effectively lowering portal pressure, correcting cytopenia, alleviating the splenic steal phenomenon, improving hepatic perfusion, and preserving certain immune function. Precise implementation includes preoperative CT angiography and three-dimensional volumetric assessment to guide decision-making, intraoperative selective or non-selective embolization strategies, multimodal material combinations to optimize outcomes, and postoperative targeted management to prevent complications such as post-embolization syndrome, splenic abscess, and portal vein thrombosis. PSE can be integrated with splenectomy, transjugular intrahepatic portosystemic shunt (TIPS), transcatheter arterial chemoembolization (TACE), and liver transplantation as preoperative conditioning, bridging therapy, or a combined approach. In conclusion, PSE is a safe, minimally invasive, and effective treatment modality that has become a core component of multimodal therapy for portal hypertension with hypersplenism. In the future, advancements in novel materials, artificial intelligence, and precise imaging technologies will further enhance its efficacy, and surgeons should actively participate in multidisciplinary collaboration to develop individualized strategies for optimizing long-term patient prognosis.