Effect Of Splenic Artery Embolization On Coagulation Function In Patients With Hypersplenism In Cirrhosis

Background Cirrhosis is a common clinical liver disease.Decompensated cirrhosis mainly manifested by hypohepatic function and portal hypertension,often accompanied by esophagogastric varices bleeding,portal vein thrombosis,splenic vein thrombosis risk.When combined with hypersplenism,peripheral hemogram can be reduced,and easily complicated with infection and bleeding.With the continuous improvement of interventional technology,splenic artery embolization(PSE)has become an alternative treatment for partial surgical splenectomy,which has been widely used in clinical practice.However,there are risks of bleeding and thrombosis after PSE.Objective To investigate the effect of splenic artery embolization on coagulation function in patients with cirrhosis and hypersplenism.Methods A total of 49 patients with cirrhosis and hypersplenism admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2016 to July 2018were enrolled.A retrospective analysis was made on the laboratory test indexes before and within 3 weeks after PSE treatment,which the laboratory test indexes included Prothrombin time(PT),activated partical thromboplastin time(APTT),international normalization ration(INR),thrombin time(TT),fibrinogen(FBG),White blood cell(WBC),hemoglobin(HGB),platelet count(PLT),total protein(TP),albumin(ALB),total bilirubin(TBIL),direct bilirubin(DBIL),alanine transaminase(ALT),aspartate transaminase(AST).Another 40 patients who underwent routine conservative treatment of cirrhosis and hypersplenism in our hospital were enrolled as a control group.Results 1 In the splenic embolism group,APTT was(46.329±11.514)s before treatment and(40.243±8.973)s after treatment;FBG was(156.994±41.801)mg/ml before treatment and(267.289±101.644)mg/ml after treatment;TT was(22.663±2.688)s before treatment and(20.600±2.437)s after treatment.There differences in APTT,FBG and TT before and after treatment in splenic embolism group were significant(P<0.05),but the difference in PT and INR before and after treatment were no significant(P>0.05). 2 In the splenic embolism group,WBC was(2.332±0.860)x10~9/L before treatment and(7.947±4.800)10~9/L after treatment;PLT was(47.060±21.438)x10~9/L before treatment and(100.870±60.051)x10~9/L after treatment;The differences in WBC and PLT before and after treatment in splenic embolism group were significant(P<0.05),while the difference in HGB before and after treatment were no significant(P>0.05). 3 In the splenic embolism group,TP was(62.733±7.416)g/L before treatment and(58.256±6.375)g/L after treatment;ALB was(35.813±5.786)g/L before treatment and(33.174±5.135)g/L after treatment;TBIL was(31.156±17.858)umol/L before treatment and(36.377±17.158)umol/L after treatment;DBIL was(11.774±6.758)umol/L before treatment and(15.146±10.182)umol/L after treatment;ALT was(43.330±45.785)u/l before treatment and(31.130±19.270)u/l after treatment;AST was(52.380±51.344)u/l before treatment and(42.740±18.215)u/l after treatment.The differences of TP,ALB,TBIL and DBTL in the spleen embolization group were statistically significant(P<0.05).The difference between the ALT and AST before and after treatment was no significant(P>0.05).Conclusion PSE can improve the coagulation function of patients with hyperslenism and cirrhosis.