Alvarez O A, Lopera G A, Patel V, Encarnacion C E, Palmaz J C, Lee M
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7878, USA.
Am J Gastroenterol. 1996 Jan;91(1):134-7.
Thrombocytopenia secondary to hypersplenism is a well-known complication of portal hypertension. The effects of transjugular intrahepatic portosystemic shunt (TIPS) on hypersplenism have not been adequately studied. In this report, we describe 11 patients who had significant improvement in their thrombocytopenia due to hypersplenism after TIPS. There was a statistically significant improvement in the platelet counts after TIPS placement, in virtually every case during the follow-up period, although some patients had platelet counts less than 100,000/mm3 at the end of the follow-up period. Statistically significant hemodynamic improvement in the gradient pressure was observed immediately after TIPS. Furthermore, all patients tolerated the procedure well, and TIPS-related complications were encountered during the follow-up period. Our data suggest that TIPS is an effective, noninvasive alternative to surgical interventions in the management of hypersplenism in cirrhotic patients, who are generally high-risk surgical candidates.
脾功能亢进继发的血小板减少是门静脉高压症的一种常见并发症。经颈静脉肝内门体分流术（TIPS）对脾功能亢进的影响尚未得到充分研究。在本报告中，我们描述了11例因TIPS术后脾功能亢进导致的血小板减少症有显著改善的患者。TIPS置入术后血小板计数有统计学意义的改善，在随访期间几乎每个病例都是如此，尽管一些患者在随访期末血小板计数低于100,000/mm³。TIPS术后立即观察到梯度压力有统计学意义的血流动力学改善。此外，所有患者对该手术耐受性良好，随访期间未出现与TIPS相关的并发症。我们的数据表明，对于通常是高风险手术候选者的肝硬化患者，TIPS是治疗脾功能亢进的一种有效、非侵入性的替代手术干预的方法。
