依诺肝素早期抗凝治疗肝硬化合并门静脉血栓形成的剂量选择、疗效及风险分析  

Dose Selection,Efficacy and Risk Analysis on Early Enoxaparin Anticoagulation in the Treatment of Liver Cirrhosis Complicated with Portal Vein Thrombosis

作　　者：李正起 Li zhengqi(Department of general surgery,Limited by Share Ltd General Hospital of Yima coal industry group 472300 Chin)

机构地区：[1]义马煤业集团股份有限公司总医院普外科,河南义马472300

出　　处：《中西医结合肝病杂志》2018年第4期151-153,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨依诺肝素早期抗凝治疗肝硬化合并门静脉血栓形成(PVT)的剂量选择、疗效及风险。方法:92例接受依诺肝素抗凝治疗的肝硬化合并PVT患者按随机数字表法分为A组和B组,每组46例,根据推荐门静脉血栓用法,A组患者采用每12h皮下注射依诺肝素1mg/kg,B组患者采用每24h皮下注射依诺肝素1.5mg/kg,比较两组患者PVT再通率、肝功能(Child-pugh)变化及抗凝期间出血不良事件发生情况。结果:治疗后A组患者PVT完全再通率和部分再通率分别为26.08%和53.35%,B组患者PVT完全再通率和部分再通率分别为23.91%和58.70%,两组患者再通率比较,差异不具有统计学意义(P>0.05)。治疗后两组患者Child-pugh评分、胆红素和肌酐含量较治疗前显著升高(P<0.05),两组患者在Child-pugh评分、胆红素和肌酐含量比较无统计学意义(P>0.05)。A组患者治疗期间其他出血事件发生率为8.7%,显著低于B组患者28.26%(P<0.05)。结论:每12h注射1.0mg/kg依诺肝素和每24h注射1.5mg/kg依诺肝素均能有效治疗肝硬化合并PVT,且前者非食管静脉曲张出血发生率较低。Objective：To explore the dose selection, efficacy and risk analysis of early enoxaparin anticoagulation in the treatment of liver cirrhosis complicated with portal vein thrombosis （PVT）. Methods： 92 cases of liver cirrhosis patients with PVT treated with enoxaparin antico- agulation were divided into the group A （ u = 46） and the group B （ u = 46） according to the random number table method. According to the rec- ommended method of deep vein thrombosis, the group A was injected subcutaneously with enoxaparin 1 mg/kg for every- 12h, and the group B was injected subcutaneously with enoxaparin 1.5 mg/kg for every- 24 h. The PVT recanalization rate and liver function （ Child - pugh） changes and the occurrence of adverse events during anticoagulation were observed and compared between the two groups. Results ：There was no statistically significant difference in the the rates of PVT complete recanalization and PVT partial recanalizafion after treatment between the group A and the group B （ 26.08% vs. 23.91% ,53.35 % vs. 58.70% ） （ P 〉 0.05）. After treatment, the Child - pugh score, bilirubin and creatinine levels were significantly higher than those before treatment （ P 〈 0.05 ）, and there was no significant difference in Child - pugh score, bilirubin and creati- nine levels between the two groups （ P 〉 0.05 ）. The incidence rate of other bleeding events in the group A was significantly lower than that in the group B （ 8.7% vs. 28.26% ） （ P 〈 0.05 ）. Conclusions ： Injection of enoxaparin with 1.0 mg/kg for every- 12 h or 1.5 mg/kg for every- 24 h can be effective in the treatment of liver cirrhosis complicated with PVT, and the former volmne can have a lower non -esophageal variceal bleeding rate.

关 键 词：依诺肝素 肝硬化 门静脉血栓 剂量 

分 类 号：R575.2[医药卫生—消化系统]