血塞通对脾切除及贲门周围血管离断术后门静脉血流动力学及门静脉血栓风险的影响  

Effect of Xuesaitong on portal vein hemodynamics and portal vein thrombosis risk after splenectomy and pericardial devascularization

作　　者：解敬伟 田玉晶 谢丽娟 李天成[1] 宋诏民[4] 李肖云[5] 郭旺盛[1] Xie Jingwei;Tian Yujing;Xie Lijuan;Li Tiancheng;Song Zhaomin;Li Xiaoyun;Guo Wangsheng(Department of Surgery,The Third Hospital of Qinhuangdao,Qinhuangdao 066000,China;Public Health Section,The Third Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Physical Examination,The Third Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Oncology,The Third Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Physiotherapy,The Third Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第三医院外一科,秦皇岛066000 [2]河北省秦皇岛市第三医院公共卫生科,秦皇岛066000 [3]河北省秦皇岛市第三医院体检科,秦皇岛066000 [4]河北省秦皇岛市第三医院肿瘤科,秦皇岛066000 [5]河北省秦皇岛市第三医院理疗科,秦皇岛066000

出　　处：《广西医科大学学报》2019年第7期1100-1103,共4页Journal of Guangxi Medical University

基　　金：秦皇岛市科学技术局基金资助项目(No.201703A048)

摘　　要：目的:探讨血塞通对脾切除及贲门周围血管离断术后门静脉血流动力学及门静脉血栓风险的影响。方法:选取2014年1月至2017年12月河北省秦皇岛市第三医院收治的肝硬化门静脉高压患者102例,均行脾切除及贲门周围血管离断术治疗。按随机数字表法分为对照组与观察组,每组51例。对照组术后采用常规补液、抗感染、阿司匹林抑制血小板聚集等治疗,观察组在对照组基础上采用血塞通治疗。比较两组治疗前、后门静脉血流动力学指标、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)、凝血酶时间(TT)],以及术后1个月内血栓发生率和不良反应发生率。结果:两组治疗后血管内径、横截面积、门静脉充血指数显著低于治疗前,血流量、血流速度显著高于治疗前,且观察组变化更为显著(均P<0.05)。与对照组比较,观察组治疗后APTT和TT延长,Fbg升高,门静脉血栓发生率降低(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:血塞通能有效改善脾切除及贲门周围血管离断术后门静脉血流动力学及凝血功能,减少门静脉血栓发生。Objective: To investigate the effect of Xuesaitong on portal vein hemodynamics and portal vein thrombosis risk after splenectomy and pericardial devascularization. Methods: A total of 102 patients with cirrhosis and portal hypertension who underwent splenectomy and pericardial devascularization in our hospital from January 2014 to December 2017 were selected,and randomly divided into a control group and an observation group,with 51 cases in each group.The patients in the control group were treated with routine fluid infusion,anti-infection and aspirin to inhibit platelet aggregation.The patients in the observation group were treated with Xuesaitong on the basis of the control group.The portal vein hemodynamic parameters and blood coagulation function indexes including activated partial thromboplastin time (APTT),prothrombin time (PT),fibrinogen (Fbg) and thrombin time (TT) were detected.The incidence of thrombosis within 1 month after operation and the incidence of adverse reactions were observed and compared between the two groups. Results: After treatment,the vascular diameter,cross-sectional area,and portal vein congestion index were decreased in both groups,while the blood flow volume and blood flow velocity were increased ( P <0.05).These changes were more marked in the observation group ( P <0.05).The APTT and TT were prolonged and the Fbg level was elevated in the observation group compared with the control group ( P <0.05).The incidence of portal vein thrombosis in the observation group was lower than that in the control group ( P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups ( P >0.05). Conclusion: Xuesaitong could effectively improve the hemodynamics and coagulation function,and reduce the risk of portal vein thrombosis in patients with cirrhosis and portal hypertension who underwent splenectomy and pericardial devascularization.

关 键 词：血塞通 脾切除 门静脉血栓 血流动力学 

分 类 号：R575[医药卫生—消化系统]