肝硬化门静脉高压性脾肿大并发脾功能亢进的特点及临床意义

Characteristics and clinical significance of hypersplenism secondary to splenomegaly caused by cirrhotic portal hypertension

肝硬化门静脉高压性脾肿大患者并发脾亢本身包含了脾肿大,因而,评价肝硬化门静脉高压症患者是否有脾亢主要依据是外周血细胞减少.然而肝硬化门静脉高压性脾肿大患者不一定都有外周血细胞减少,他是肝硬化门静脉高压性脾肿大的并发症,而不是其必然表现.对于该病的治疗,外科手术一方面可以消除巨脾和/或重度外周血细胞减少,还可以止血,因而绝大多数患者均可采用手术治疗.但对肝硬化门静脉高压性脾肿大无外周血细胞减少、无巨脾、无出血史的患者可采用非手术治疗.

The diagnosis of hypersplenism secondary to cirrhotic portal hypertension is primarily based on the presence of peripheral blood cytopenia. However, patients with cirrhotic portal hypertension-induced splenomegaly do not always develop peripheral blood cytopenia. As surgery permits eliminating massive splenomegaly/hypersplenism, improving peripheral blood cytopenia and preventing the occurrence of hemorrhage, it is indicated for the majority of patients with cirrhotic portal hypertensioninduced splenomegaly. Non-surgical treatments are indicated for patients without massive splenomegaly, peripheral blood cytopenia and history of hemorrhage.