低分子肝素早期使用预防断流术后门静脉系血栓形成

Prevention of low molecular weight heparins, which was early administrated after devascularization operation, on thrombosis of portal vein

目的研究断流术后早期使用低分子肝素对门静脉系统血栓形成的预防作用。方法选取肝硬化门脉高压症患者200例,随机分成低分子肝素组与对照组,每组100例,均行脾切除及贲门周围血管离断术,低分子肝素组术后使用低分子肝素钙治疗(4 100 IU,皮下注射,每日1次, 连用10 d),对照组进行常规治疗。比较两组间血栓发生率、术后再出血情况及生存情况。结果低分子肝素组断流术后门静脉系统血栓发生率(6．25％)明显低于对照组(17．35％,P<0．05)。低分子肝素组治疗期间无出血顷向等不良反应。门静脉系统血栓形成组再出血率(21．74％)明显高于无血栓形成组(5．26％,P<0．05)。结论低分子肝素早期使用预防断流术后门静脉系血栓形成,是安全、有效的,且使用方便,值得推广。

Objective To investigate the prevention effect of LMWH, which was early administrated after devascularization operation, on thrombosis of portal vein. Methods 200 patients of liver cirrhosis and portal hypertension were random divided into two groups（LMWH group and control group）, 100 patients in each group. They all had an devaseularization operation and spleneetomy. LMWH group were treated by LMWH （4 100 IU/d×10 d） while control group didn＇t have. The occur rate of portal vein thrombus, recurrent bleeding rate after operation and exist time were compared between two groups. Results The occur rate of portal vein thrombus after devaseularization operation in LMWH group （6.25 % ） were signifieandy lower than control group （17.35 %, P 〈 0.05）. Patients with portal vein thrombus had a high recurrent bleeding rate than the ones with no portal vein thrombus （P 〈 0.05）. Conclusion LMWH, which was early administrated after devaseularization operation, had a peHect prevention effect on thrombosis of portal vein. It was safe and easy.