| 摘要: |
| 【】目的 血小板减少症通常会增加肝硬化患者经颈静脉肝内门体分流术(TIPS)的术后上消化道出血的风险。我们回顾性评价功能性脾动脉栓塞术(FSE)与TIPS术对血小板减少肝硬化患者的长期影响。患者与方法 共入选50例确诊血小板减少症并进行了TIPS的肝硬化患者,其中30例行单纯TIPS术,其中20例患者在TIPS术后行FSE术治疗。对术后外周血细胞计数的变化及术后并发症进行了评价。结果 经过一年的随访,TIPS FSE治疗组与TIPS组相比平均血小板计数明显升高(P <0.05)。 FSE表现对血小板的保护的积极影响,表现在平均血小板体积(MPV)血小板,分布宽度(PDW),大型血小板比率(P-LCR)在每一个相关的时间点都比TIPS组低(P <0.05)。在TIPS FSE治疗组中人均血小板输注数更少,人均住院天数更短(P <0.05)。结论 伴有血小板减少的肝硬化患者在TIPS的术后,FSE可进一步提供一个稳定长期的升血小板作用,并减少血小板输注的需求,并缩短住院天数。 |
| 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 血小板减少。 |
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| The?long-term?effect?of?functional?splenic?artery?embolization?with?transjugular intrahepatic portosystem stent-shunt?on?the?thrombocytopenia?of?cirrhosis?patients |
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Chen Xuyan, Chen Renpin, Wu Jiansheng, Huang Zhiming, Wu Wei
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The First Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Purpose:?Thrombocytopenia?usually?increases?the?risk?of?upper?gastrointestinal?hemorrhage?in?cirrhosis?patients?after?transjugular?intrahepatic?portosystemic?shunt?(TIPS).?In?this?study,?the?long-term?effect?of?functional?splenic?artery?embolization?(FSE)?with?TIPS?on?the?thrombocytopenia?of?cirrhosis?patients?was?retrospectively?assessed.?Patients?and?methods?:A?total?of?50?cirrhosis?patients?with?confirmed?thrombocytopenia?underwent?TIPS,?in?which?20?patients?were?treated?with?FSE?after?TIPS.?FSE-related?complications?and?effects?on?platelet?counts?were?evaluated.?Results:?At?the?one?year?follow?up,?the?mean?platelet?counts?were?significantly?elevated?(p<0.05)?in?the?TIPS+FSE?group?compared?with?the?TIPS?group.?FSE?showed?a?platelet-protective?effect?as?the?mean?platelet?volume,?platelet?distribution?width,?and?platelet-large?cell?rate?were?correspondingly?lower?in?the?TIPS?group?at?every?time?point?(p<0.05).?The?per?capita?number?of?platelet?transfusion?and?per?capita?duration?of?inpatient?stay?was?much?lower?in?the?TIPS+FSE?group?(p<0.05).?Conclusions:?In?cirrhosis?patients?with?thrombocytopenia?after?TIPS,?FSE?could?further?provide?a?stable?long-term?increase?in?platelets?and?reduce?the?need?for?platelet?transfusions?and?inpatient?stay. |
| Key words: Functional splenic artery embolization Transjugular intrahepatic portosystemic shunt Cirrhosis thrombocytopenia. |