Hassab术后门静脉系统血栓形成原因及预防

The causes and prevention of portal vein thrombosis after the Hassab’s operation

目的探讨肝硬化病人行Hassab术后门静脉系统血栓形成(PVT)的原因、诊治及预防。方法对浙江大学医学院附属第一医院1999-2004年200例接受Hassab手术的病人进行回顾性分析。结果26例病人发现门静脉系统的血栓形成,发病率为13%(26/200),抗凝治疗后均顺利出院,无一例死于该并发症。结论Has sab术后并发PVT病因尚未明确,血小板峰值>300×109/L是危险因素;其诊治关键在于早期发现和及时抗凝溶栓治疗,预防性抗凝并不能明显降低发生率。

Objective To discuss the pathogenesis, diagnosis, therapy, and precaution of the portal vein thrombosis （PVT） after Hassab＇ s operation, Methods Two hundred patients who underwent Hassab＇ s operation because of liver cirrhosis with portal hypertension between 1999 and 2004 in the First Affiliated Hospital of Medical College of Zhejiang University were analyzed retrospectively. Results Twenty-six patients developed PVT after operation （ 13% ）, and all of them discharged smoothly after anticoagulant therapy. Conclusion The definite cause of PVT after Hassab＇ s operation is still unclear. The peak value of plate which exceeded 300 ×10^9/L is a risk factor. The preventive anticoagulation can not decrease incidence of PVT. The key point of therapy is early diagnosis and early anticoagulant treatment.