| 摘要: |
| 目的探讨功能性脾动脉栓塞术（FSE）与经颈静脉肝内门体分流术（TIPS）对PLT减少肝硬化患者外周血细胞变化的影响。方法选取2013年12月至2015年12月诊治的肝硬化伴PLT减少的患者50例，其中行单纯TIPS术30例（TIPS组），TIPS术后行FSE术治疗20例（TIPS+FSE组）。评估两组患者术前3d、术后3d、3个月、6个月、1年外周血细胞计数，并发症发生情况，并分析随访1年影响PSE术后PLT增加的因素。结果TIPS+FSE组PLT在术后6个月和1年均增高（均P＜0.05），但WBC及Hb差异无统计学意义（均P＞0.05）。TIPS组和TIPS+FSE组轻微并发症和严重并发症的发生率差异均无统计学意义（均P＞0.05）。相关性分析显示，年龄、FSE术前PLT、FSE术前血小板压积、FSE术前血小板-大细胞比率是预测FSE术后1年PLT增加的重要因素（均P＜0.05）。结论伴有PLT减少的肝硬化患者在TIPS后，FSE可进一步起到稳定长期的升PLT作用，减少PLT输注需求，缩短住院时间。 |
| 关键词: 功能性脾动脉栓塞术 经颈静脉肝内门体分流术 肝硬化 PLT 减少 |
| DOI：10.12056/j.issn.1006-2785.2018.40.5.2017-800 |
| 分类号: |
| 基金项目:浙江省科技计划项目（2015C33120） |
|
| Long-term effect of functional splenic artery embolization and transjugular intrahepatic portosystemic shunt on blood cell counts in cirrhotic patients with thrombocytopenia |
|
|
|
the First Affiliated Hospital of Wenzhou Medical University
|
| Abstract: |
| Objective To investigate the effect of functional splenic artery embolization(FSE) and intrahepatic portal shunt (TIPS) on peripheral blood cell counts in patients with thrombocytopenia. Methods Fifty cirrhotic patients with thrombocytopenia admitted from December 2013 to December 2015 were enrolled in the study. Among 50 patients 30 were treated with simple TIPS (TIPS group), and 20 were treated with TIPS and followed FSE surgery (TIPS + FSE group). The peripheral blood cell counts were measured at 3d before surgery, 3d and 3, 6 months and 1 year after surgery, the complications were also documented in two groups. The factors related to the increase of PLT after FSE were also analyzed. Results The platelet (PLT) count in TIPS + FSE
group was higher than that in TIPS group 6 months and 1 year after surgery (all P ＜0.05), while there were no statistically
significant differences in white blood cell (WBC) count and hemoglobin values (all P ＞0.05) between two groups. There was no significant difference in the incidence of mild and severe complications between TIPS group and the TIPS + FSE group. Correlation analysis showed that age, preoperative PLT count, preoperative thrombocytocrit and preoperative PLT to large cell ratio were predicting factors for the increase of PLT 1 year after FSE (all P＜0.05). Conclusion TIPS and FSE provide a stable long-term effect of platelet increase, a decreased needs of platelet transfusion and hospitalization for cirrhotic patients with thrombocytopenia. |
| Key words: Functional splenic artery embolization Transjugular intrahepaticportosystemic shunt Cirrhosis Thrombocytopenia |
