摘要
目的探讨脾切除术后门静脉血栓（PSVT）形成的危险因素及防治方法。方法搜集2004年1月至2008年12月行脾切除的86例病例资料，根据手术后是否行抗凝治疗分为抗凝组（n=47）和对照组（n=39），术后第1、2、4、8、12周分别行门静脉多普勒超声检查，明确是否存在门静脉系统血栓，同时检查血小板计数及D-二聚体。结果PSVT发生率为12．64％，抗凝组术后12周共有3例并发PSVT，发生率为6．38％，形成时间在第2周2例，第4周1例。对照组39例中门静脉血栓形成8例，发生率为20．51％。第2周6例，第4周2例。抗凝组与治疗组比较，差异有统计学意义，巨脾术后PSVT发生率为20．7％，地中海贫血脾切除术后PSVT发生率为20％，均较其他类型高。结论巨脾及血液系统疾病脾切除术后PSVT发生率高。血栓形成高峰在术后第2～4周。术后抗凝治疗能够降低门静脉系统血栓发生率。
Objective To investigate the risk factors,incidence of portal vein thrombosis（PSVT） and the prophylactic methods of portal vein thrombosis develepment after splenectomy. Methods Eighty-six cases were included in this research,which were derived from the patients who underwent splenectomy during Janaury,2004 to December,2008. The cases were divided into coagulation group （47） and control group （39） according to whether anticoagulation therapy was carried out. Doppler ultrasonography of the portal vein and the platelet count, the concentrate of D-dimer were tested in 1,2,4,8,12 weeks postoperatively. Results The incidence of PSVT after spenectomy was 12.64 %. Three cases in the coagulation group developed PVST in the following 12 weeks, and the incidence was 6.38%. PSVT of two cases were diagnosed in 2 week,and one in 4 week. Eight cases developed PSVT in the control group and the incidence was 20.51 %, which was different signifficantly from the coagulation group. Six cases were diag- nosed with PSVT in 2 weeks postoperatively,and 2 in 4 weeks. The incidence of PSVT in patients with massive splenomegaly was 20.7% ,and 20.0% in patients with thalassemia. Both of them were much higher than other types. Conclusion The patients with massive splenomegaly and hemopathic diseases have high risks to develop PSVT when spleneetomy performed. The peak time of thrombosis development was during 2 weeks to 4 weeks after spleneetomy. Coagulation therapy may reduce the incidence of thrombosis complications of the portal vein after splenectomy.
出处
《重庆医学》
CAS
CSCD
北大核心
2009年第21期2698-2700,共3页
Chongqing medicine
关键词
脾切除术后
门静脉血栓
抗凝治疗
splenectomy
portal vein thrombosis
anticoagulant therapy
