门静脉高压症断流手术后门静脉血栓形成的调查  

Portal vein thrombosis after devascularization procedures in patients with portal hypertension

作　　者：邓美海[1] 邓鹏[1] 林楠[1] 钟跃思[1] 胡昆鹏[1] 许瑞云[1] 

机构地区：[1]中山大学附属第三医院肝胆外科,广州510630

出　　处：《中华普通外科杂志》2007年第8期616-618,共3页Chinese Journal of General Surgery

基　　金：广东省科技计划基金资助项目（2004B35001007）

摘　　要：目的探讨乙肝肝硬化门静脉高压症手术后门静脉血栓形成（PVT）的发生率、分布、分级、转归及其对肝功能的损害。方法回顾性分析我院1997年9月至2006年3月间乙肝肝硬化门静脉高压症手术415例患者的临床资料，根据彩色多谱勒了解术后PVT的发生情况及血栓的分级、分布等，并通过病例对照分析研究PVT对肝功能的近期影响。结果本组415例门静脉高压症术后彩超复查率为46．8％，PVT的发生率是33．5％。2004年后的近2年PVT的发生率为39．8％，其中在术后1个月内PVT的发生率达到39．6％。与非血栓患者相比，PVT可引起血清转氨酶的明显升高（P〈0．05）。结论PVT在乙肝肝硬化门静脉高压症术后有较高的发生率，且主要发生在术后1个月以内。在门静脉高压症术后应尽早采取措施以预防和治疗门静脉血栓的形成。Objective To investigate the incidence, distribution, grade and prognosis of the portal vein thrombosis （ PVT ） after portaazygous devaseularization in portal hypertensive patients. Methods Between September 1997 and March 2006, Spleneetomy,esophagogastrie devaseularization with or without an additional endoscopic varieeal ligation were performed on 415 cirrhotic patients with portal hypertension. Data were analyzed retrospectively. The incidence, distribution and grade of PVT were determined by color Doppler sonography, and its impact on the liver function was analyzed by ease control study. Results The uhrasonography follow-up rate was 46. 8%, PVT was detected in 33.5% patients. The rate of PVT reached 39.8% in patients followed up during recent two years, of which 39.6% PVT was detected within 1 month after operation. The levels of transaminase in PVT group were signifieandy higher than those in non-PVT group （ P 〈 0. 05 ）. Condnsion Portaazygous devaseularization is associated with a considerable high rate of PVT especially in one month postoperatively which demands an early preventive measures.

关 键 词：高血压 门静脉 血栓形成 脾切除术 

分 类 号：R686[医药卫生—骨科学]