摘要
目的探讨门静脉高压症术后门静血栓形成(Portal Vein Thrombosis,PVT)相关因素。方法回顾性分析我院2001年04月至2008年12月采用脾肾分流术加贲门周围血管离断联合手术和贲门周围血管离断术治疗129例肝硬化门静脉高压症患者的临床资料,对患者年龄、性别、门静脉直径、门脉脉直径、门静脉血流流速的变化、门静脉压力变化、血小板数值等相关指标监测分析,评估门静脉高压症患者术后门静者术后门静脉血栓形成相关因素。结果门静脉高压症患者术后门静脉血栓形率为15.50%(20/129),其中断流手术后门静脉系统血栓形成率为18.18%(16/88),联合手术后血栓形成率为9.76%(4/41)。血栓组患者门静脉主干直径、脾静脉直径较非血栓组患者增宽,有显著性差异。术后血全组PV、SV的流速下降显著(P<0.05)。血栓组患者术前、术后门静脉压力均较无血栓组患者低,有统计不差异(P<0.05)年龄,性别,肝功能child-pugh分级,凝血酶原时间,术后血小板增高等因素不是脾切除术后门静脉血栓形成的危检因素。结论门脉高压脾切除术后门静脉主干直径、脾静直径增宽,门静系统血液流速减缓,门静脉压力降低有显著性差异,是门脉高压脾切除术后门静脉血栓形成的危除因素。进一步的大样本的随机对照临床研究对解决这个问题是必要的和重要的。
Objective To investigate the Risky Fators, the incidence and causes of postoperative portal vein thrombosis （PVT）in pativets. Methods The clinical data of 129 patients with portal hypertention receiving devascularization or devarization with spleno-renal shunt operation （combination group）in our hospital from 2001 to 2008 were retrospectively analyzed. The data of patients about age, sex were collected to be analyzed, the level of platrorm was examined, and the diameter and the blood flow of portal vein were measured by Doppler ultrasonography. Results PVT occurred after operation in 20 of 129 patients （ 20/129,15.50% ）. The incoidenee of PVT in devascularization group was 18.18% （ 16/88 ）. The incidence of PVT in combination group was 9.76% （4/41）. The diameter of the portal vein and the splenic vein of the patients with PVT increased more than that of those without PVT（ P 〈 0. 05 ）, and the blood flowof the portal vein in patients with PVT was slower than that in those without PVT（P 〈0. 05）. The FPP the patients with PVT was lower than that of those without PVT（P 〈0. 05）. There were no significant differences of the sex, the Child-pugh classification, prothrombin time and platlet counting in the two groups of patients with or without PVT （P 〉 0. 05 ）. Conclusions The risk factors of PVT are the increased diameter of the portal vein and the splenic vein,the alleviation of the blood flowof portal vein, and the lower FPP. Well-designed randomized studies on the PVT after splenetomy are urgently are urgently needed.
出处
《肝胆外科杂志》
2009年第3期184-187,共4页
Journal of Hepatobiliary Surgery
