Department of Surgery, People's Hospital of Hainan Province, Haikou, China.
Asian Pac J Trop Med. 2013 Aug;6(8):663-6. doi: 10.1016/S1995-7645(13)60115-7.
To explore peripheral blood cell variations in hepatic cirrhosis portal hypertension patients with hypersplenism.
Clinical data of 322 hypersplenism patients with decreased peripheral blood cells, admitted with cirrhotic portal hypertension, was retrospectively studied over the last 17 years.
In 64% (206/322) of patients, more than 2 kinds of blood cell were decreased, including 89 cases of pancytopenia (43.2%), 52 cases of WBC + PLT decrease (25.2%), 29 cases of RBC + PLT decrease (14.1%), and 36 cases of WBC + RBC decrease (17.5%); in 36% (116/322) of patients, single type blood cell decrease occurred, including 31 cases of PLT decrease (26.7%), 29 cases of WBC decrease (25%) and 56 cases of RBC decrease (48.3%). Of 227 routine bone marrow examinations, bone marrow hyperplasia was observed in 118 cases (52.0%), the remainder showed no hyperplasia. For the distinct scope and extent of peripheralblood cell decreases, preoperative blood component transfusions were carried out, then treated by surgery, after whole group splenectomy, the peripheral blood cell count was significantly higher (P<0.05).
Of portal hypertensive patients with splenomegaly and hypersplenism, 64% have simultaneous decrease in various blood cells, 36% have decrease in single type blood cells, 52% of patients have bone marrow hyperplasia. A splenectomy can significantly increase the reduction of peripheral blood cells.
探讨肝硬化门静脉高压症合并脾功能亢进患者外周血细胞变化。
回顾性分析 17 年来收治的 322 例外周血细胞减少的肝硬化门静脉高压症合并脾功能亢进患者的临床资料。
64%（206/322）的患者有两种以上血细胞减少，包括全血细胞减少 89 例（43.2%）、白细胞+血小板减少 52 例（25.2%）、红细胞+血小板减少 29 例（14.1%）、白细胞+红细胞减少 36 例（17.5%）；36%（116/322）的患者发生单一类型血细胞减少，包括血小板减少 31 例（26.7%）、白细胞减少 29 例（25%）、红细胞减少 56 例（48.3%）。227 例行常规骨髓检查，骨髓增生 118 例（52.0%），无增生 109 例。根据外周血细胞减少的明显程度和范围，术前进行血液成分输注，然后手术治疗，全组脾切除后，外周血白细胞计数明显升高（P<0.05）。
肝硬化门静脉高压症伴脾肿大、脾功能亢进患者中，64%同时存在多种血细胞减少，36%存在单一类型血细胞减少，52%患者骨髓增生。脾切除术可显著增加外周血血细胞减少。
