[1]白耀威,刘家成,熊 斌,等.血小板减少症患者经颈静脉肝内门体分流术安全性和预后分析[J].介入放射学杂志,2022,31(08):765-769.
　BAI Yaowei,LIU Jiacheng,XIONG Bin,et al.TIPS in patients with thrombocytopenia： analysis of clinical safety and prognosis[J].journal interventional radiology,2022,31(08):765-769.
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血小板减少症患者经颈静脉肝内门体分流术安全性和预后分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年08
页码:
765-769
栏目:
血管介入
出版日期:
2022-09-30

文章信息/Info

Title:
TIPS in patients with thrombocytopenia： analysis of clinical safety and prognosis
作者:
白耀威;  刘家成;  熊 斌;  杨崇图;  王迎亮;  周 晨;  黄松江;  李铜强;  陈 杨
Author(s):
BAI Yaowei;  LIU Jiacheng;  XIONG Bin;  YANG Chongtu;  WANG Yingliang;  ZHOU Chen;  HUANG Songjiang;  LI Tongqiang;  CHEN Yang.
Department of Radiology， Affiliated Union Hospital， Tongji Medical College， Huazhong University of Science and Technology； Hubei Province Key Laboratory of Molecular Imaging， Wuhan， Hubei Province 430022， China
关键词:
【关键词】 肝硬化;  门静脉高压症;  经颈静脉肝内门体分流术;  血小板减少症
文献标志码:
A
摘要:
【摘要】 目的 探讨肝硬化门静脉高压伴血小板减少症患者接受经颈静脉肝内门体分流术（TIPS）治疗的安全性和预后。方法 回顾性选取2015年11月至2021年5月在武汉协和医院接受TIPS术治疗的229例门静脉高压患者，根据术前患者血小板计数（PLT）分为重度血小板减少组（PLT＜40×109/L，n=44）和轻度血小板减少组（PLT 40～100×109/L，n=185）。绘制术后肝肾功能折线图，采用Kaplan-Meier曲线分析比较两组患者临床预后。 结果 所有患者均成功实施TIPS术，技术成功率为100%。围手术期无严重并发症发生。重度血小板减少组、轻度血小板减少组术前平均PLT分别为（30.5±7.7）×109/L、（65.1±16.9）×109/L，术后肝肾功能指标变化趋势无显著差异。随访期间，重度血小板减少组、轻度血小板减少组1年支架功能障碍发生率分别为2.4%、6.9%，2年支架功能障碍发生率分别为5.9%、11.4%，两组间差异无统计学意义（HR=0.80，95%CI =0.25～2.52，Log-rank P=0.723）；两组间累积生存率（Log-rank P=0.685）、再出血或再发腹水率（Log-rank P=0.357）和显性肝性脑病发生率（Log-rank P=0.753）差异均无统计学意义。 结论 对凝血功能正常或轻度异常（凝血酶原时间延长不超过5 s）的血小板减少症（PLT＞20×109/L）患者行TIPS术是安全的，血小板减少症严重程度与经TIPS治疗肝硬化门静脉高压患者预后无关。

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备注/Memo

备注/Memo:
（收稿日期：2021-08-19）
（本文编辑：边 佶）
更新日期/Last Update: 2022-09-26