肝移植术后终末期肝病患者脾功能亢进的恢复情况  

The improvement of preoperative hypersplenism in patients with end-stage liver diseases following liver transplantation

作　　者：向璐 李晶 张达利 刘佳 张晓峰 XIANG Lu;LI Jing;ZHANG Da-li;LIU Jia;ZHANG Xiao-feng(Senior Department of Hepatology,the Fifth Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100039,China;Department of Anesthesia Surgery,the Fifth Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心肝病医学部,北京100039 [2]解放军总医院第五医学中心麻醉手术科,北京100039

出　　处：《肝脏》2025年第2期180-182,共3页Chinese Hepatology

摘　　要：目的探索肝移植术后终末期肝病患者的脾功能亢进恢复情况。方法纳入2015年3月至2019年3月于解放军总医院第五医学中心行肝脏移植术的患者156例。分为术前脾脏长度≥170 mm(严重脾大组)和<170 mm(脾大组)。结果156例患者中,严重脾大组65例,脾大组91例。肝移植术后1年严重脾大患者的白细胞计数为3.30×10^(9)/L、血小板计数为107.6×10^(9)/L、脾脏长度为150.0 mm、门静脉灌注为1647 mL/min、脾大患者分别为4.63×10^(9)/L、149.0×10^(9)/L、125.5 mm、1300 mL/min,2组比较差异均有统计学意义(均P<0.05)。结论术前严重脾大患者肝移植术后易于出现白细胞、血小板水平下降、门静脉灌注高。Objective To explore the improvement of preoperative hypersplenism in patients with end-stage liver diseases(ESLD)following liver transplantation.Methods The data of 156 ESLD patients who underwent liver transplantation from March 2015 to March 2019 were investigated.All patients were classified into a severe splenomegaly group(N=65)and a splenomegaly group(N=91)based on whether their spleen diameter≥170 mm or<170 mm.The improvement of preoperative hypersplenism was compared between these two groups.Results The white blood cell counts were 3.30×10^(9)/L and 4.63×10^(9)/L(P<0.001),platelet counts were 107.6×10^(9)/L and 149.0×10^(9)/L(P<0.001),spleen diameters were 150.0 mm and 125.5 mm(P<0.001),and portal hyper-perfusion were 1647 mL/min and 1300 mL/min(P=0.001)in patients with severe splenomegaly and splenomegaly,respectively,after one year post liver transplantation.There were significant differences between the two groups.Conclusion Patients with severe splenomegaly had lower white blood cell and platelet counts and more severe portal hyper-perfusion compared to those patients with splenomegaly.

关 键 词：肝移植 门静脉高灌注 脾大 血小板 白细胞 

分 类 号：R657.3[医药卫生—外科学]