冷沉淀在门奇静脉断流术治疗门静脉高压患者中的应用

Application of cryoprecipitate in patients treated by portaazygous devascularization

目的探讨使用冷沉淀对降低门奇静脉断流术围手术期大出血等风险的作用,及其对术后并发症的影响。方法 68例门脉高压患者实施脾切除、门奇静脉断流术。患者随机分为两组,34例为冷沉淀使用组,于术中输注冷沉淀10单位;34例为对照组,术中不使用冷沉淀。比较两组患者术后创面出血情况、凝血酶原时间、术后恢复情况及消化道再出血、门静脉系统血栓等并发症的发生率等。结果与对照组比较,输注冷沉淀的门奇静脉断流患者,术后创面失血明显减少,腹腔内及消化道大出血的发生率降低。患者恢复较快,术后平均住院日低于对照组。门静脉系统血栓等并发症不高于对照组。结论门奇静脉断流术中输注冷沉淀可改善凝血机能,有效预防围手术期大出血的发生,有助于患者术后恢复。其使用未增加门静脉系统血栓等并发症的发生,安全有效。

Objective To evaluate the effect of cryoprecipitate - based blood component therapy on reducing perioperative risk in patients treated with portaazygous devascularization and to assess its influence on risk of post -operative complications. Methods Sixty -eight patients with portal hypertension who were scheduled for portaazygous devascularization were randomly assigned to receive either the standard surgery （control group, n = 34） or surgery combined with perioperative transfusion of 10U cryoprecipitate （treatment group, n = 34）. Data recorded for inter -group comparative analysis （t -test） included postoperative blood loss, prothrombin time, and recovery time, as well as incidences of re - hemorrhage in the gastrointestinal tract and of portal vein thrombosis. Results Compared with the control group, the cryo-precipitate - transfused patients showed significantly lower amount of blood loss after surgery and significantly lower incidence of postoperative bleeding and of re - hemorrhage in the gastrointestinal tract. The cryoprecipitate - transfused patients also experienced a shorter duration re- covery period, with less days of in - hospital stay. There was no increase in the incidence of portal vein thrombosis after the use of cryopre- cipitate. Conclusion Application of cryoprecipitate during portaazygous devascularization surgery is safe and can improve coagulation function and reduce the risk of perioperative bleeding. Perioperative cryoprecipitate administration also benefits postoperative recovery and does not increase the incidence of portal vein thrombosis.