肝硬化并门静脉血栓的相关治疗分析

Therapeutic analysis of cirrhosis with portal vein thrombosis

目的探讨肝硬化并门静脉血栓发生的相关危险因素及治疗。方法参考随机数字表法的要求在肝硬化并门静脉血栓患者中抽取60例作为观察组,并根据是否采取抗凝治疗分为观察1组(抗凝组)32例和观察2组(未抗凝组)28例,同样应用随机数字表法从单纯肝硬化患者中选取280例作为对照组,收集入组患者可能和门静脉血栓发生有关的危险因素并进行统计学分析。结果通过单因素分析发现,血红蛋白(Hb)含量、血小板(Plt)计数、凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶原活动度(PTA)、Child-Pugh评分、腹腔积液、食管静脉曲张程度是诱发肝硬化并门静脉血栓发生的相关危险因素(P<0.05);将有统计学意义的肝硬化并门静脉血栓发生的相关危险因素导入二元logistic回归分析发现,Hb含量、Plt计数、脾切除病史是导致肝硬化并门静脉血栓发生的独立危险因素(P<0.05);随访半年,观察1组的32例患者经超声检查提示门静脉血栓完全消失或血管再通恢复超过一半以上为24例,治疗总有效率为75.00%,观察2组的28例患者经超声检查提示门静脉血栓完全消失或血管再通恢复超过一半以上为6例,治疗总有效率为21.43%,观察1组的有效率明显增加且组间比较差异有统计学意义(χ~2=16.30,P<0.05)。结论 Hb含量、Plt计数、PT、INR、PTA、Child-Pugh评分、腹腔积液、食管静脉曲张程度是诱发肝硬化并门静脉血栓发生的相关危险因素,其中Hb含量、Plt计数、脾切除病史是导致其发生的独立危险因素,临床必须密切监视上述指标变化,预防和见门静脉血栓的发生,给予抗凝治疗可明显提高治疗效果。

Objective To investigate the risk factors and treatment of cirrhosis complicated with portal vein thrombosis. Methods According to random number table method, 60 patients with cirrhosis and portal vein thrombosis treated in our hospital from January 2018 to January 2019 were selected and divided into observation group 1(anticoagulation group, n=32) and observation group 2(non-anticoagulation group, n=28). And 280 patients with simple cirrhosis treated in our hospital from January 2018 to January 2019 were selected as the control group. The risk factors related to the occurrence of portal vein thrombosis were collected and analyzed. Results Univariate analysis showed that the levels of hemoglobin(Hb), platelet count(Plt), prothrombin time(PT), international standardized ratio(INR), prothrombin activity(PTA), Child-Pugh score(score), ascites and esophageal varices were the risk factors for hepatocirrhosis complicated with portal vein thrombosis(P<0.05). Hb, Plt count and history of splenectomy were independent risk factors for cirrhosis with portal vein thrombosis(P<0.05). With the half-year follow-up, the total effective rates in anticoagulation group and non-anticoagulation group were 75.00% and 21.43%, respectively;with significant difference between the 2 groups(P<0.05). Conclusion Hb, Plt, PT, INR, PTA, Child-Pugh score, ascites and degree of esophageal varices are the related risk factors for liver cirrhosis complicated with portal vein thrombosis, among which Hb, Plt and history of splenectomy are independent risk factors leading to the occurrence of portal vein thrombosis.