脾切除断流术后经脾静脉抗凝治疗预防早期门静脉血栓的安全性分析

The safety of indwelling catheter via spleen vein to prevent early portal vein thrombosis after splenectomy and esophagogastric devascularization

目的评价经脾静脉置管抗凝治疗预防脾切除断流术后早期门静脉血栓(PVT)形成的安全性。方法 60例择期行脾切除断流术的门脉高压患者随机分为置管组和对照组,采用超声多普勒和(或)强化螺旋CT扫描监测术后门静脉血栓形成情况。结果 60例患者全部随访到3个月。对照组累计PVT发生率56.7%,置管组为16.7%,两组有统计学差异(P<0.05)。经脾静脉置管输入肝素溶液对体循环静脉血凝血酶原时间和活化部分凝血活酶时间无影响。结论经脾静脉置管抗凝治疗预防脾切除断流术后早期门静脉血栓形成是安全可行的。

Objective To evaluate the safety of early anticoagulation via spleen vein for the prevention of portal vein thrombosis（PVT） after splenectomy and esophagogastric devascularization.Methods Sixty patients treated with splenectomy and esophagogastric devascularization were randomized into two groups： indwelling catheter group and control group.Doppler ultrasound and/or CT were used for the diagnosis of PVT.Results All cases were followed-up in three months.In control group,the total PVT rate was 56.7%,and in indwelling catheter group 16.7%.PVT incidence was significantly reduced in indwelling catheter group in contrast with the control group（P0.05）.Heparin infusion through spleen vein had no side-effect.Conclusion Infusion of heparin through indwelling catheter via spleen vein is safe in the prevention of early PVT after splenectomy and esophagogastric devascularization.