脾动脉栓塞术对肝硬化脾功能亢进患者凝血功能的影响

Effect of splenic artery embolization on coagulation in patients with hypersplenism due to cirrhosis

目的探讨脾动脉栓塞术对肝硬化脾功能亢进患者凝血功能的影响。方法选取2016年1月—2018年7月新乡医学院第一附属医院收治的49例肝硬化脾功能亢进患者作为脾栓塞组。回顾性分析患者脾动脉栓塞术治疗前及治疗后3周内凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、国际标准化比值(INR)、凝血酶时间(TT)及纤维蛋白原(FIB)的变化。另选取本院同期收治的采用常规保守治疗的40例肝硬化脾功能亢进患者作为对照组。结果脾栓塞组APTT治疗前后分别为(46.063±11.477)和(40.243±8.973)s,FBG治疗前后分别为(155.346±39.930)和(267.289±101.644)mg/ml,TT前后分别为(22.860±2.749)和(20.600±2.437)s。脾栓塞组APTT、FIB及TT指标治疗前后比较,差异有统计学意义(P <0.05);而PT、INR治疗前后比较,差异无统计学意义(P>0.05)。结论脾动脉栓塞术能够降低门静脉系统压力、减轻脾亢进功能症状,还可以改善肝硬化脾亢患者的凝血功能。

Objective To investigate the effect of splenic arterial embolization on coagulation function in patients with liver cirrhosis and hypersplenism. Methods In the experimental group, 49 patients with hypersplenism due to cirrhosis admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2016 to July 2018 were selected. The changes of PT, APTT, INR, TT and FBG before and within 3 weeks after splenic artery embolization were analyzed retrospectively. In the control group, 40 patients with cirrhosis and hypersplenism were treated conservatively. Results The levels of APTT were (46.063±11.477) s before treatment and (40.243±8.973) s after treatment;The levels of FBG were (155.346±39.930) mg/ml before treatment and (267.289±101.644) mg/ml after treatment;The levels of TT were (22.860±2.749) s before the treatment and (20.600±2.437) s after treatment. The changes of APTT, FBG and TT were statistically significant before and after operation in the experimental group (P < 0.05), but there was no statistical difference in PT and INR (P > 0.05). Conclusions Splenic arterial embolization can reduce the pressure of portal vein system, alleviate symptoms of hypersplenism, and improves the coagulation function of cirrhotic patients with splenic hypersplenism.