Han Xiaoyu, Lv Yunfu, Li Yejuan, Deng Jie, Qiu Qingan, Liu Ning, Zhao Shuya, Liao Caixian
1 Department of Liver Vascular Surgery, Nangfang Hospital, Southern Medical University, Guangzhou 510515, China.
2 Department of General Surgery, Hainan Provincial People's Hospital, Haikou 570311, China.
J Int Med Res. 2018 Jul;46(7):2633-2640. doi: 10.1177/0300060518767550. Epub 2018 May 20.
Objectives To investigate peripheral cytopenia in patients with splenomegaly due to hepatitis B-related cirrhotic portal hypertension (HBRCPH) by comparing blood cell counts from enlarged spleens with peripheral blood. Methods This prospective study involved patients undergoing splenectomy at the Nangfang Hospital from June 2013 to December 2015. Blood cell counts from peripheral blood were compared with those from splenic blood taken during splenectomies. Results Clinical data were available from 30 patients. White blood cell (WBC), red blood cell (RBC) and platelet counts were statistically significantly lower in peripheral blood compared with splenic blood. After splenectomy, peripheral blood cell counts increased significantly compared with pre-operative levels. Platelet and WBC counts in the lower spleen were significantly higher than those in the porta lienis (middle segment) and upper spleen. Conclusions In patients with splenomegaly due to HBRCPH, the counts of three blood cell lineages were significantly higher in the spleen than in peripheral blood. Splenectomy can aid the return of peripheral blood cell counts to normal levels. The most significant retention of platelets and WBCs occurred in the lower spleen which may be useful information for surgeons performing partial splenectomies.
目的 通过比较因乙型肝炎相关肝硬化门静脉高压(HBRCPH)导致脾肿大患者肿大脾脏的血细胞计数与外周血血细胞计数,研究外周血细胞减少情况。方法 这项前瞻性研究纳入了2013年6月至2015年12月在南方医院接受脾切除术的患者。将外周血血细胞计数与脾切除术中采集的脾血血细胞计数进行比较。结果 30例患者有临床数据。外周血白细胞(WBC)、红细胞(RBC)和血小板计数与脾血相比在统计学上显著降低。脾切除术后,外周血细胞计数与术前水平相比显著增加。脾脏下部的血小板和白细胞计数明显高于脾门(中段)和脾脏上部。结论 在因HBRCPH导致脾肿大的患者中,脾脏中三种血细胞系的计数明显高于外周血。脾切除术有助于外周血细胞计数恢复到正常水平。血小板和白细胞在脾脏下部的潴留最为显著,这可能为进行部分脾切除术的外科医生提供有用信息。