关键词: 肝细胞癌, 肝硬化, 血小板减少症, 手术, 重组人血小板生成素, 治疗

Abstract: Objective The efficacy of platelet transfusions in increasing platelet counts is variable and may be associated with side effects. The aim of this study was to investigate whether the administration of recombinant human thrombopoietin (rhTPO) could reduce preoperative blood transfusion in patients with liver cirrhosis and hepatocellular carcinoma (HCC) and thrombocytopenia. Methods 40 patients with liver cirrhosis and thrombocytopenia and 36 patients with HCC and thrombocytopenia were recruited in XiJing Hospital From January 2017 through April 2019, and they underwent operations such as esophageal variceal ligation or endoscopic gastric varices tissue adhesive injection for gastroesophageal varices or transcatheter arterial chemoembolization or microwave ablation for cancers. Before operation, the rhTPO was administered once daily for 12 days. Results Of the 76 patients, 23 patients had peripheral platelet count at 40-50×10⁹/L, and 53 patients had it at < 40×10⁹/L; the blood platelet counts in the two groups increased significantly on the 8th day of treatment [>50×10⁹/L, (76.0±26.6)×10⁹ / L and (54.4±24.3)×10⁹ / L, respectively], peaked on the 12th day [(95±34.8)×10⁹ / L and (67.9±25.1)×10⁹ / L, respectively],and dropped to the baseline levels at 30^th days [42.3±5.3)×10⁹ / L and (23.5±4.6)×10⁹ / L, respectively]; the administration of rhTPO had no side effects on blood coagulation parameters and no portal vein thrombosis was found in the two groups. Conclusion The application of rhTPO could be as an alternative therapy for preoperative platelet transfusion in patients with thrombocytopenia and liver diseases, with the ability to reduce risk of intraoperative bleeding, which needs further study.

Key words: Hepatoma, Liver cirrhosis, Thrombocytopenia, Operation, Recombinant human thrombopoietin, Therapy