门静脉高压症肝移植术后血小板的变化及影响因素分析

目的：探讨门静脉高压症保留脾脏肝移植术后近期血小板的变化规律和影响血小板变化的因素.方法：在手术前和手术后第3,7,14,28d分别检测病人血小板数目,计算样本均数,以曲线图显示血小板变化规律.将样本均数与感染组同期血小板均数比较,并分析感染等因素对术后血小板计数的影响.结果：门静脉高压症保脾肝移植术后第3d血小板处于最低值,术后7d回升,术后14d后逐渐接近正常.感染组在术后3d血小板亦处于低值,7d后逐渐回升,术后7,14d明显低于同期非感染组（P=0.05）.结论：门静脉高压症保留脾脏肝移植术后7d内血小板低于正常值,多种因素可影响术后血小板的变化.血小板计数对判定病人预后有一定意义.

Study of the Changes of Platelet and Its Influencing Factors after Liver Transplantation with Portal Hypertension

Objective:To investigate the regularity of thrombocytic changes of patients suffered from portal hypertension after orthotopic liver transplantation (OLT) and to analyze its influencing factors.Methods:The value of preoperative platelet count and the platelet counts at 3,7,14 and 28 postoperative days were detected,respectively.The mean of the samples was calculated and compared with the platelet count of infectious group and analyzed with statistics.Results:Platelet count of patient suffered from portal hypertension before OLT was significantly lower than the normal count and reached a nadir at 3rd post-transplant day and approached to normal gradually at 14th post-OLT day.The mean of the samples was higher than that of the infectious group at 14th postoperative day of OLT (P=005).Conclusions:Platelet count decreased further from baseline in the transplanted patients within 7 days after OLT.Many factors influenced the values of postoperative platelet count.Analysis of them of postoperative platelet might serve as a method to assess the prognosis of patients.