断流术后门静脉系统血栓形成的研究

Study of thrombosis of portal vein after devascularization operation

目的研究断流术后门静脉系统血栓形成的临床特征,为其防治提供线索。方法回顾性分析肝硬化门脉高压症行断流术病人194例,研究其门静脉系统血栓形成情况,与PT、KPTT及PLT的关系,再发上消化道出血及生存情况。结果该组门静脉系统血栓发生率为13.92%,血栓组与无血栓组PT、KPTT及PLT水平均无明显差异(P>0.05),无血栓形成组再出血率明显低于血栓形成组(P<0.05)。结论断流术后预防门静脉系统血栓形成是降低再出血率的重要一环。抗凝药物应在术后早期(PLT超过正常前)使用。

[Objective] To investigate the clinical characteristic of thrombosis of portal vein after devascularization operation, and find out the key for prevention. [Methods] Retrospectively analyze 194 patients with hver cirrhosis and portal hypertension who had a devascularization operation. The characteristic of portal vein thrombus, its connection with PT, KPTr and PLT, the recurrent bleeding rate after operation and existing time were studied. [Resuits] The oecuring rate of portal vein thrombus after devascularization operation was 13.92%. There were no significent differences of PT, KPTT and PLT between the patients with portal vein thrombus and the one without it （P 〉 0.05）. Patients with portal vein thrombus had a higher recurrent bleeding rate than the ones with no portal vein thrombus （P 〈0.05）. [Conclusion] The prevention of portal vein thrombus after devascularizafion operation, was very important to decrease the recurrent bleeding rate after operation. The anti-coagulation therapy should be early administrated after devascularization operation（before the PLT level higher than normal）.