Journal de l'hypertension : accès libre

Objective: This study aimed to investigate the changes in peripheral blood cells after two groups of splenectomy in patients with traumatic rupture of the spleen and portal hypertension group, as well as causes and prevention and treatment of splenectomy related portal vein thrombosis.
Methods: Clinical data from 109 patients with traumatic rupture of the spleen who underwent splenectomy in our hospital from January 2001 to August 2015 were retrospectively analyzed, and compared with those from 240 patients with splenomegaly due to cirrhotic portal hypertension who underwent splenectomy over the same period.
Results: After splenectomy, peripheral platelet (PLT) count was significantly increased in both groups (P<0.01), and the increase was significantly greater in the traumatic rupture group than in the portal hypertension group (P<0.05). The red blood cell (RBC) count remained unchanged (P>0.05), while the white blood cell (WBC) count was significantly decreased (P<0.05) in the traumatic rupture group. Both WBC and RBC counts were increased significantly (P<0.05) in the portal hypertension group. Both groups received routine anticoagulant therapy after splenectomy. The incidence of portal vein thrombosis was 8.26% and 6.67% in the traumatic rupture and portal hypertension groups (P>0.05), respectively, which was alleviated with urokinase.
Conclusion: The significant increase of peripheral PLT count in both groups after splenectomy might be caused by the removal of the site that stored blood cells. The more significant increase of PLT in the traumatic rupture group might be related to a constant production and release of thrombopoietin by the normal liver into blood circulation. The lack of increase of RBC count in the traumatic rupture group indicated no storage of RBCs in the spleen, and the significant increase of WBC count was related to the control of inflammation. The significant increase of WBC and RBC counts in the portal hypertension group was related not only to the elimination of spleen storage, but also to the elimination of hypersplenism. Postoperative routine anticoagulant and thrombolytic therapy could prevent and treat portal vein thrombosis.

Background: Hypertension is one of lifestyle-related diseases, and prevention and effect of reduction pressure can be expected by non-pharmacological interventions. Authors have continued guidance of adjustment for lifestyle to thousands of hypertensive patients, resulting 4.6%-6.1% case could discontinue hypertensive agents. This study enrolled patients with all necessary related data.
Subjects and methods: Subjects were 50 patients with hypertension (M/F: 25/25, age 65.4 ± 8.6 vs. 53.4 ± 6.2 years, BMI 23.4 ± 2.7 vs. 22.3 ± 2.5, respectively), who could discontinued antihypertensive agents. They received consultation and intervention from registered dietitian nutritionists, exercise therapists and nurses.
Results: The comparative results on males and females are as follows: smoking habit was 76% vs. 0%, alcohol intake was 60% vs. 0%, diabetes complication was 16% vs. 8%, and hyperlipidemia was 32% vs. 52%, respectively. These cases showed rare to none incidence of cerebral vascular accident (CVA), coronary heart disease (CHD) and chronic kidney disease (CKD). Consultations in median were 4.0 vs. 4.0 times, median weight reduction was 2.2 kg vs. 1.6 kg and median period withdrawal of the drug was 2.0 years vs. 2.5 years.
Discussion and conclusion: When living adjustment is advised, blood pressure decreases due to behavior change. Our results suggest that these cases have less arteriosclerosis development, which enables withdrawal of medicine. It is necessary to carefully observe the progress whether the antihypertensive drug will be unnecessary or will be restarted. Current results obtained would become the fundamental data in the future, and the adjustment for diet and exercise would be useful for more adequate treatment for hypertension.