摘要
目的:探究低分子肝素钙用于晚期肝硬化合并门静脉血栓(PVT)患者的治疗作用,及对上消化道出血风险和预后的影响。方法:98例晚期肝硬化合并PVT患者随机分为对照组和观察组各49例。对照组给予阿司匹林常规抗凝,观察组给予低分子肝素钙抗凝治疗,两组均治疗9个月并随访。比较两组患者治疗前后总胆红素(Tbil),白蛋白(Alb)、国际标准化比值(INR)、门静脉系统指标水平,以及随访期间的累计PVT再通情况、上消化道出血发生情况、患者总生存率。结果:治疗后,两组患者TBil均显著低于治疗前,Alb、INR则显著高于治疗前(P<0.05),门静脉、脾静脉血流量均显著高于治疗前,PVT体积显著低于治疗前(P<0.05);且观察组上述各项指标均优于对照组(P<0.05)。随访期间,观察组患者的PVT再通情况明显高于对照组(P<0.05),上消化道出血发生风险和死亡风险均明显低于对照组(P<0.05)。结论:给予晚期肝硬化患者低分子肝素钙治疗,可有效改善肝功能,提高PVT再通率,降低上消化道出血风险,并改善患者预后,同时安全性有保证。
Objective: To explore the effect of low molecular heparin on portal vein thrombosis (PVT) in patients with advanced cirrhosis and its impact on the risk and prognosis of upper gastrointestinal bleeding. Methods: Totally 98 patients with advanced cirrhosis complicated with PVT were divided into the control group (49 cases) and the experimental group (49 cases) by random number table method. The control group was given aspirin routine anticoagulation,and the experimental group was given low molecular weight heparin calcium anticoagulation. Both groups were treated for 9 months with follow-up. The levels of total bilirubin (Tbil),albumin (Alb),international standardized ratio (INR) and portal vein system were compared between the groups before and after the treatment.The cumulative PVT recanalization,the incidence of upper gastrointestinal bleeding,the overall survival rate and the incidence of adverse reactions were recorded and compared between the groups during the follow-up period. Results: After the treatment,Tbil of the two groups was significantly lower than that before the treatment,Alb and INR were higher than those before the treatment (P<0.05),and the changes in the experimental group were more obvious (P<0.05). After the treatment,the blood flow of portal vein and splenic vein in the two groups was significantly higher than that before the treatment,and the volume of PVT was significantly lower than that before the treatment (P<0.05). The changes of the above three indices in the experimental group were more obvious than those in the control group (P<0.05). The recanalization of PVT in the experimental group was significantly higher than that in the control group (P<0.05),the risk of upper gastrointestinal bleeding was significantly lower than that in the control group (P< 0.05),and the risk of death was significantly lower than that in the control group (P<0.05). Conclusion: Low molecular weight heparin can effectively improve liver function,increase the recanalization rate of PVT,reduce the risk of upper gastrointestinal bleeding,improve the prognosis of patients with advanced cirrhosis and ensure the safety.
作者
依巴古力.艾拜都拉
胡利萍
张跃新
孙晓风
Yibaguli·Aibaidula;Hu Liping;Zhang Yuexin;Sun Xiaofeng(Center for Infectious Diseases,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中国药师》
CAS
2019年第3期496-498,503,共4页
China Pharmacist
基金
新疆维吾尔自治区自然科学基金项目(编号:2016D01C278)
关键词
晚期肝硬化
低分子肝素钙
门静脉血栓
上消化道出血
预后
Advanced cirrhosis
Low molecular heparin
Portal vein thrombosis
Upper gastrointestinal bleeding
Prognosis
