脾切除术后门静脉系统血栓形成的临床分析  

Clinical analysis of portal vein thrombosis after splenectomy

作　　者：李铁汉[1] 唐波[1] 田大广[1] 付必莽[1] 朱洪[1] 唐继红[1] 张捷[1] 

机构地区：[1]昆明医学院第二附属医院肝胆胰外科,650101

出　　处：《腹部外科》2010年第6期341-343,共3页Journal of Abdominal Surgery

摘　　要：目的探讨脾切除术后门静脉血栓形成（portal vein thrombosis，PvT）和肠系膜静脉血栓形成（mesenteric venous thrombosis，MVT）的成因及诊治策略。方法回顾性分析2000年以来脾切除术后门静脉血栓形成及肠系膜静脉血栓形成12例的临床资料。结果280例脾切除后血栓发生12例（4．3％），其中发生PVT9例（3．2％），发生MVT3例（1．1％）。9例经积极的全身抗凝、祛聚、溶栓治疗1～2周后好转出院。血栓形成病人均出现白细胞增多，血小板计数升高，D-二聚体检测和凝血功能异常，与治疗后1周相比，差异均有统计学意义（P〈0．05）。2例行小肠切除肠吻合术。1例死于肝功能衰竭。结论脾切除后动态检测血常规、凝血功能等相关指标是预防静脉血栓形成的有效措施，及早诊断和治疗对病人康复起关键作用。Objective To study the factors and the treatment methods of portal vein thrombosis （PVT） and mesenteric venous thrombosis（MVT） after spleneetomy. Methods Since the year 2000, clinical materials of patients with PVT and MVT after sptenectomy were analyzed retrospectively. Results Venous thrombosis occurred in 12 of the 280 patients after splenectomy （4. 3 %）..9 patients presented with PVT （4. 3 %） and 3 with MVT （1.1%）. Leukocytosis occurred, platelet count was increased, D-dimer was positive, thromboplastic function was abnormal in 9 patients with thrombosis, which was significantly different from those one week after treatment（P〈0. 05）. All patients were all cured by anti-coagulation and thrombus dissolving. Two cases were subjected to intestine-intestine anastomosis after small bowel resection. One died of hepatic failure. Conclusion Early diagnoses and treatment of vein thrombus is key of recovery.

关 键 词：脾切除术 门静脉 肠系膜静脉 血栓形成 

分 类 号：R657.34[医药卫生—外科学]