摘要
目的分析肝炎肝硬化脾大患者行脾切除术前后血小板变化情况及其影响因素。方法收集2003年1月至2008年12月在西安交通大学医学院第二附属医院住院的70例肝炎肝硬化脾亢患者,回顾性分析行脾切除术前后血小板、肝功能、骨髓涂片等结果。结果按Child-Pugh分级的A、B、C三组肝硬化患者中,切脾后血小板回升到正常的比例分别是97.6%(40/41)、79.2%(19/24)和60%(3/5);肝功能分级与术后的血小板数量恢复相关,肝功能损害越轻,血小板恢复越理想(P<0.05);血小板恢复高低与术前骨髓增生情况没有明显的相关性。结论脾切除术是治疗肝炎肝硬化脾亢血小板减少症的主要有效方法,术前肝功能整体评价可以帮助预测切脾后血小板的恢复状况。
Objective To analyze the change of platelet count in patients with posthepatitic cirrhosis after the splenectomy and its related factors.Methods Seventy cases of posthepatitic cirrhosis with hypersplenism were enrolled who were hospitalized in the Second Affiliated Hospital of Medical College of Xi＇an Jiaotong University from January 2003 to December 2008.Patients＇ data including platelet count,liver function and myelogramm before and after the splenectomy were retrospectively analyzed.Results Patients were divided into three groups according to the Child-Pugh classification.The percentage of patients whose platelet counts were normalized after operation was 97.6%（40/41）in stage A,79.2%（19/24）in stage B and 60%（3/5）in stage C respectively.Correlation was found between the Child-Pugh classification and the normalized platelet count.And the less liver function was impaired,the higher platelet counts were elevated（P0.05）.No remarkable correlation was found between the levels of bone marrow proliferation and elevated platelet count after the splenectomy.Conclusion Splenectomy is one of the main effective treatments for thrombocytopenia in posthepatitic cirrhosis patients with hypersplenism.Evaluation of liver function before splenectomy may help to predict the recovery of platelet count.
出处
《肝脏》
2010年第4期251-253,共3页
Chinese Hepatology
基金
国家自然科学基金资助项目(30670961)
关键词
肝炎肝硬化
血小板计数
脾切除术
Posthepatitic cirrhosis
Platelet count
Splenectomy
