部分脾动脉栓塞术治疗肝硬化并发脾功能亢进患者血常规、肝功能的变化

Effect of partial splenic artery embolization on peripheral blood counts and liver function in liver cirrhosis patients with hypersplenism

[目的]分析部分脾动脉栓塞术治疗肝硬化并发脾功能亢进对血常规、肝肾功能、凝血功能的影响。[方法]回顾性分析281例首次行部分脾动脉栓塞术患者的临床资料,比较术前与术后的血常规、肝肾功能及凝血功能临床指标。[结果](1)血常规检查:术后红细胞、血红蛋白较术前未见明显变化,白细胞、血小板分别从2.33×10^(9)/L、44×10^(9)/L恢复至3.26×10^(9)/L、71×10^(9)/L(P<0.01);(2)肝肾功能:术后丙氨酸氨基转移酶、天冬氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰转肽酶、白蛋白、Child-pugh评分及肾功能等指标未见明显变化;(3)凝血功能:术后活性部分凝血活酶时间、纤维蛋白原、凝血酶时间未见明显变化,凝血酶原时间、国际标准化比率分别从15.8 s、1.28下降至15.4 s、1.24(P<0.01)。[结论]部分脾动脉栓塞术不仅能缓解患者的白细胞减少症、血小板减少症,也有助于患者肝脏的合成功能部分恢复。

[Objective]The purpose of this study was to analyze the effect of partial splenic artery embolization on liver cirrhosis complicated with hypersplenism on peripheral blood counts,liver and kidney function,and coagulation function.[Methods]A total of 281cirrhotic patients with hypersplenism receiving PSAE treatment for the first time were enrolled in this retrospective study from Dec 2013to Dec 2020.[Results]The median age of the patients with hypersplenism underwent PSAE treatment was 54.62years(range,27-77years),and 72.4%of them were male.Significant changes in leukocyte count,platelets,prothrombin time,international normalized ratio were found in patients after partial splenic artery embolization.[Conclusion]Partial splenic artery embolization can effectivrly improve the leukopenia and thrombocytopenia of the patients with hypersplenism and liver synthetic function.