Course of thrombocytopenia of chronic liver disease after transjugular intrahepatic portosystemic shunts (TIPS). A retrospective analysis.
Course of thrombocytopenia of chronic liver disease after transjugular intrahepatic portosystemic shunts (TIPS). A retrospective analysis.
复制标题
经颈静脉肝内门体分流术（TIPS）后慢性肝病血小板减少症的病程。
DOI：
10.1007/bf02285211
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发表时间：
1995
影响因子：
3.1
通讯作者：
Bilir,BM
中科院分区：
文献类型：
--
作者：
Lawrence,SP;Lezotte,DC;Durham,JD;Kumpe,DA;Everson,GT;Bilir,BM
与慢性肝病相关的血小板减少是一个难以处理的问题。大多数报告得出结论，在这种情况下，门腔静脉分流术和远端脾肾分流术不能改善血小板计数。经颈静脉肝内门体分流术后血小板减少的反应尚未被研究。对21例肝内分流术后患者的所有血小板计数在术前1个月、术后1个月每周、术后每月至6个月进行回顾性测定。分流前和分流后血小板平均值的比较显示，分流后门脉压力梯度为12 mm Hg的患者的血小板计数显著增加，且在手术后一周内明显增加。当将寻找前的血小板减少作为唯一变量时，这种反应并不明显。这项研究表明，当达到这些压力梯度时，经颈静脉肝内门体分流术可能会改善与肝硬变相关的血小板减少。
Thrombocytopenia associated with chronic liver disease presents a difficult management issue. Most reports conclude that portocaval and distal splenorenal shunts do not improve platelet counts in this setting. The response of thrombocytopenia after transjugular intrahepatic portosystemic shunt placement has not been studied. All platelet counts of 21 patients undergoing intrahepatic shunt placement were determined retrospectively to accumulate values at one month prior to procedure, weekly for the first month after the procedure, and monthly thereafter to six months. Comparison of pre- and postshunt platelet means showed a significant increase in counts in patients with a postshunt portal pressure gradient <12 mm Hg, with the increment evident by one week after the procedure. This response was not seen when preshunt thrombocytopenia was used as the lone variable. This study suggests that the transjugular intrahepatic portosystemic shunt may improve the thrombocytopenia associated with liver cirrhosis when these pressure gradients are attained.