脾切除术后早期抗凝预防门静脉血栓形成的临床分析  

Clinical analysis of early anticoagulation therapy for the prevention of portal vein thrombosis after splenectomy

作　　者：刘雄友[1] 高德山[1] 高新华[1] 

机构地区：[1]河南省濮阳市人民医院普外科,457000

出　　处：《临床外科杂志》2013年第1期18-19,共2页Journal of Clinical Surgery

摘　　要：目的分析早期抗凝在脾切除术后预防门静脉血栓形成中的临床疗效及安全性。方法因肝炎后肝硬化门静脉高压症拟施行脾切除＋贲门周围血管离断术的64例患者随机分为两组：试验组（早期使用抗凝）34例，对照组（非抗凝组）30例，对两组进行对比分析，利用彩色多普勒超声监测静脉血栓形成情况。结果64例患者均随访6个月以上，试验组术后门静脉血栓发生率为5．8％（2／34），明显低于对照组（非抗凝组）的16．7％（5／30），差异有统计学意义（P〈0．05）。术后1周两组间血小板（PLT）、凝血酶原时间（PT）、活化部分凝血酶原时间（APPT）、纤维蛋白原（FIB）比较差异无统计学意义（P〉0．05）。结论脾切除术后早期抗凝治疗能安全有效地降低门静脉血栓的发生率。Objective To evaluate the efficacy and safety of early anticoagulation therapy in pre- venting portal vein thrombosis （PVT） in patients after splenectomy. Methods The clinical data of 64 cases with portal hypertension who received splenectomy and perieardial devascularization were retrospectively analyzed. All patients were randomized into two groups after operation,including 34 cases with early antico- agulation therapy and 30 cases with conventional treatment. Comparison analysis was performed between the groups. Color Doppler ultrasonography was used for the supervision of PVT. Results All patients were followed up for more than 6 months. The incidence rate of PVT in early anticoagulation therapy group was 5.8 % （ 2/34）, which was significantly lower than the 16.7 % （5/30） in conventional treatment group （ P 〈 0.05 ）. Alterations on platelet count, prothrombin time, prothrombin time and fibrinogen in the first week after operation did not show any significant difference between the groups （ P 〉 0.05 ）. Conclusion Early anticoagulation therapy can efficiently and safely reduce morbidity of PVT after splenectomy.

关 键 词：脾切除 抗凝法 门静脉血栓 

分 类 号：R657.6[医药卫生—外科学]