肝硬化门静脉高压症并发外周血细胞减少的病因及其构成比研究  

Peripheral cytopenia and its contituent ratio in cirrhotic portal hypertension

作　　者：吕云福[1] 刘允怡[2] 吴鸿飞[1] 宫晓光[1] 韩晓玉[1] 刘宁[1] 胡艳芬[1] 黎业娟 Lyu Yunfu;Lau Wan Yee;Wu Hongfei;Gong Xiaoguang;Han Xiaoyu;Liu Ning;Hu Yanfen;Li Yejuan(Department of General Surgery,Hainan Province People＇s Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院普外科,海口570311 [2]香港中文大学医学院沙田医院普外科 [3]海南省妇幼保健院生殖医学中心

出　　处：《中华普通外科杂志》2018年第7期559-562,共4页Chinese Journal of General Surgery

基　　金：海南省科技合作专项资金资助项目（KJHZ2015-28）;海南省科技重点研发资助项目（ZDYF2016158）

摘　　要：目的探讨肝炎性肝硬化门静脉高压症脾肿大患者并发外周血细胞减少的病因及其构成比，以利于选择治疗。方法回顾性分析海南省人民医院收治的肝炎性肝硬化门静脉高压症脾肿大并发外周血细胞减少183例患者的临床资料。结果全组患者均行脾切除术，术前均伴有1种或多种外周血细胞减少，累计血细胞减少390例次。脾切除后79．2％患者的外周血细胞减少计数恢复至正常值以上水平；15．9％患者的外周血细胞计数减少虽有上升，但未达到正常值水平：4．4％患者的外周血细胞计数在术后早期反而比术前低。5例患者在术后早期死亡。结论大部分肝硬化门静脉高压脾肿大患者并发外周血细胞减少是由于脾功能亢进引起的。脾切除术是治疗脾功能亢进的有效方法。Objective To investigate the causes of peripheral cytopenia in patients with posthepatitic cirrhosis and portal hypertensive splenomegaly. Methods The clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia who were operated in our hospital in the past 17 years were retrospectively studied. Results All these patients underwent splenectomy. Before operation, all these patients had one or more types of peripheral cytopenia （cumulative cytopenia： 390 patient-times）. After splenectomy, blood counts in 79.2% returned to normal; in 15.9% increased but failed to reach normal levels; and in 4. 9% became lower than before operation. 5 patients died soon after operation. Conclusion Hypersplenism is the main cause for the peripheral cytopenia most cirrhotic portal hypertension patients. Splenectormy is an effective method to treat hypersplenism.

关 键 词：高血压 门静脉 血细胞减少 脾功能亢进 

分 类 号：R575.2[医药卫生—消化系统]