断流术后门静脉系统血栓形成的原因及防治  

The cause,prevention and treatment of the portal vein thrombosis following pericardial devascularization with splenectomy

作　　者：李永[1] 张昕辉[1] 姜新春[1] 孟凡军[1] 

机构地区：[1]徐州市中心医院普外科,江苏徐州221006

出　　处：《徐州医学院学报》2010年第4期259-260,共2页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨门静脉高压症患者行贲门周围血管离断术后门静脉系统血栓形成的原因、预防和治疗方法。方法回顾性分析我院87例门静脉高压症行脾切除加贲门周围血管离断术患者的临床资料。结果原位脾切除加传统断流术18例,原位脾切除加选择性贲门周围血管离断术69例。术后并发门静脉系统血栓形成9例(10.3%),其中传统断流术3例(16.7%),选择性贲门周围血管离断术6例(8.7%)。经抗凝、溶栓治疗后8例血栓完全消失,1例基本消失,未发生严重并发症。结论原位脾切除、选择性贲门周围血管离断术可降低门静脉系统血栓形成发生率。加强围手术期管理可有效预防和治疗门静脉系统血栓形成。Objective To investigate the cause,prevention and treatment of portal vein thrombosis（PVT） following pericardial devascularization with splenectomy.Method The clinical data of 87 patients undergoing orthotopic splenectomy and devascularization were retrospectively analyzed.Result There were 18 cases of orthotopic splenectomy plus traditional pericardial devascularization and 69 cases of orthotopic splenectomy plus selective pericardial paraesophsgastric devascularization.There were 9 cases complicated with PVT（13.6%）： 3 cases（16.7%） of traditional pericardial devascularization and 6 cases（8.7%） of selective pericardial paraesophsgastric devascularization.Subsequent to anticoagulative and thrombolytic treatment,8 cases were completely remedied and one case had remission with no serious complications.Conclusions The technique of orthotopic splenectomy plus selective pericardial devascularization can decrease the incidence of PVT.Enhanced perioperative management is a key to effective prevention and treatment of PVT.

关 键 词：门静脉高压症 贲门周围血管离断术 脾切除术 血栓形成 

分 类 号：R657.44[医药卫生—外科学]