摘要
目的探讨肝硬化脾脏切除后门静脉系统血栓形成的原因,并且对各种可能的影响因素进行分析总结。方法回顾性分析本院于2009年2月-2012年2月收治的216例肝硬化脾脏切除术后患者的临床资料,分别对患者的性别、年龄、门静脉和脾静脉的直径、脾脏的大小、肝功能分级、术后并发症、手术前后的门静脉血液流速和压力、手术前后的血小板数量和凝血酶原延长时间等因素进行考察和分析。结果脾切除术后发生门静脉血栓(portal vein thrombosis,PVT)36例,未发生PVT 180例。术后发生PVT患者的门静脉和脾静脉的直径、脾脏的大小、术后门静脉血液流速、手术前后门静脉的压力以及术后并发症的情况与发生门静脉血栓有显著性关联,差异有统计学意义(P<0.05),但是患者的性别、年龄、肝功能分级、手术前后的血小板数目、术前门静脉血液流速和手术前后的凝血酶原延长时间与门静脉血栓的形成无显著性关联,差异无统计学意义(P>0.05)。结论门静脉和脾静脉直径较粗、脾脏较大、手术后门静脉血液流速较慢、手术前后门静脉压力较小以及手术后并发症较多是肝硬化脾切除术后PVT形成的主要危险因素,因此可针对上述指标及时对患者的术后情况进行检测,减少肝硬化脾切除术后PVT的形成,促进患者术后康复。
Objective To explore the risk factors of portal system thrombosis after splenectomy in patient,analyze and summary the various possible influencing factors.Methods 216 patients with liver cirrhosis received in our hospital from Feb.2009 to Feb.2012 undergone splenectomy were analyzed retrospectively.The patient＇s gender,age,diameter of portal vein and splenic vein,spleen size,liver function,postoperative complications,the blood flow rate and pressure of postoperative portal vein,platelet count and prothrombin extending time before and after surgery were examined and analyzed.Results 36 PVT cases occurred after splenectomy,180 cases did not occur.The diameter of portal vein and splenic vein,spleen size,blood flow and pressure of portal vein before and after surgery and postoperative complications of the patients of PVT after splenectomy were significantly associated to portal vein thrombosis,the difference was statistically significant（P0.05）.The patient＇s gender,age,liver function,platelet count before and after the surgery,blood flow of intraoperative portal vein before and after surgery,prothrombin extending time were not associated with portal vein thrombosis,the difference was not statistically significant（P0.05）.Conclusion The thicker of portal vein and splenic vein diameter,larger of spleen,slower of surgical portal vein blood flow,smaller of portal vein pressure before and after surgery and the more of postoperative complications,the more likely to occur PVT in the patients with cirrhosis after liver spleen resection,in a word,doing various postoperative detection with above indicators timely can reduce the formation of PVT in the patients of liver cirrhosis with spleen resection and promote the rehabilitation of patients.
出处
《胃肠病学和肝病学杂志》
CAS
2012年第10期941-943,共3页
Chinese Journal of Gastroenterology and Hepatology
