肝内胆管结石患者门静脉血栓形成的相关危险因素分析  

Risk factors of portal vein thrombosis in patients with calculus in intrahepatic duct

作　　者：施建设[1] 张诚华[1] 潘建生[1] 

机构地区：[1]解放军第180医院普外科,福建泉州362000

出　　处：《岭南现代临床外科》2013年第1期25-28,共4页Lingnan Modern Clinics in Surgery

基　　金：军队科技创新经费资助项目(102023)

摘　　要：目的探讨肝内胆管结石患者门静脉系统血栓形成(PVT)的相关危险因素。方法对本院2010年5月至2012年5月期间收治的89例患肝内胆管结石行部分肝切除术患者进行回顾性分析,并对其门静脉组织标本进行病理切片观察,发现其中22例患者有门静脉系的静脉血栓形成(血栓组),其余67例患者作为对照组。将患者术前所检测血小板数量、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(d-dimer)、组织纤溶酶原激活物剂(t-PA)水平及生化肝肾功能等纳入研究,进行统计学分析。结果统计结果发现,术前D-二聚体水平升高是肝内胆管结石患者PVT形成的危险因素(OR=15.89,95%CI:3.89-71.36,P=0.002),研究未能提示年龄、性别、血小板数量和APTT等传统凝血指标是PVT形成的危险因素。结论对术前D-二聚体水平升高的肝内胆管结石患者进行早期干预,可能有助于预防和减少其门静脉血栓发生。Objective To evaluate the risk factors of portal vein thrombosis （PVT） in calculus of intrahepatic duct patients. Methods Eighty-nine of patients diagnosed as calculus of intrahepatic duct from 2010 to 2012 in our hospital were reviewed, including 22 cases with PVT in thrombosis group and 67 without PVT in the control group. The platelet count, prothrombin time （PT）, activated partial prothrombin time（AFIT）,fibrinogen （Fib） and d-dimer and t-PA in all patients were analyzed. Results According to analysis of statistical results, the increased d-dimer was a risk factor （OR= 15.89, 95% CI： 3.89-71.36, P=0.002）. No differences were found in age, gender and APTT, Fib, PT and t-PA. Conclusion For preoperative elevated serum D-dimer in the patients with calculus of intrahepatic duct, early interventional management would attribute to prevention and reduce portal vein thrombosis.

关 键 词：结石 肝内胆管 门静脉血栓形成 D-二聚体 

分 类 号：R575.62[医药卫生—消化系统]