术中十二指肠镜下乳头切开术128例报告

Clinical analysis of portal vein thrombosis after splenocaval shunt plus devascularization in treatment of portal hypertension

目的 探讨脾腔分流联合断流术治疗门静脉高压症术后门静脉系统血栓形成的临床特征,为防治提供线索.方法 回顾性分析接受脾腔静脉分流联合断流术治疗的110例门静脉高压症病人及接受断流术的92例病人术后门静脉血栓形成、诊治以及继发消化道再出血情况,并比较两种术式对门静脉系统血栓形成的影响.结果 联合手术组术后门静脉系统血栓发生率10.O%,再出血率3.6%,低于断流组的22.8%（P〈0.05）和10.8%（P〈0.05）.结论 脾腔静脉分流联合断流术是减少门静脉系统血栓形成的理想术式,术后早期抗凝治疗对预防血栓形成具有重要意义.

Objective To explore the clinical characteristics of portal vein thrombosis（PVT） after splenocaval shunt plus devascularization in treatment of portal hypertension and find Out ways for its prevention.Methods The formation,diagnosis,treatment of PVT and variceal rehemorrhage in 110 patients with portal hypertension who received splenocaval shunt plus devascularization procedures （Combined Group）and 92 patients subjected to pericardial devascularization operation（PCDV Group） were retrospectively analyzed.Meanwhile,the effect of two procedures on PVT was compared.Results The incidence of PVT was 10.0%in combined group and 22.8%in PCDV group （P〈0.05）.The rebleeding rate from esophagogastric varices because of PVT in combined group was 3.6%,which was significantly lower than that of 10.8%in PCDV group（P〈0.05）.Conclusion Splenoeaval shunt plus devascularization is a better choice to decrease the incidence of PVT.The postoperative anti-coagulation therapy in the early stage is important for the prevention of PVT.