肝硬化脾功能亢进患者部分脾动脉栓塞术后早期门静脉血栓形成的预防  

Precautionary effect of portal vein thrombosis in liver cirrhosis with hypersplenism patients after partial splenic artery embolization(PSE)

作　　者：蒋忠宝 刘金明[2] 万萍 张克勤[2] JIANG Zhongbao;LIU Jinming;WAN Ping(Department of infenction,people’s hospital of Zhangshu City;Department of Liver Diseases,The Ninth Hospital of Nanchang,Nanchang 330000,China)

机构地区：[1]江西省樟树市人民医院感染科,樟树331200 [2]南昌市第九医院肝五科,南昌330000

出　　处：《江西医药》2021年第7期907-909,945,共4页Jiangxi Medical Journal

基　　金：江西省卫计委普通科技课题,NO:20172228。

摘　　要：目的探讨部分脾动脉栓塞术(PSE)后所致的早期门静脉血栓形成(portal vein thrombosis,PVT)预防措施。方法2010年4月至2019年12月我院行PSE患者1849例,纳入研究者1169例。据华法林钠片、低分子右旋糖酐的应用情况分为:A组257例,术后未用药;B组389例,术后当天即予华法林钠片;C组523例,术后当天即予低分子右旋糖酐。统计各组的PVT、消化道出血等发生率。结果术后15天内A组、B组、C组发生PVT的例数分别为30例、27例和31例,发生率分别为11.7%、6.9%和5.9%。A组PVT发生率明显高于B组(χ^(2)=4.308,P=0.038)、C组(χ^(2)=7.892,P=0.005),而B组和C组的PVT发生率无统计学差异(χ^(2)=0.385,P=0.535)。3组术后7天血小板计数升高、凝血酶原延长时间比较无统计学差异(P>0.05)。结论PSE术后早期干预能有效预防PVT。Objective To study the precautionary effect of portal vein thrombosis in patients with hypersplenism after partial splenic artery embolization(PSE),and find a way to prevent the portal vein thrombosis.Methods 1169 patients were selected from 1849 cases with hypersplenism after partial splenic artery embolization(PSE)in our hospital from April 2010 to December 2019.ALL the patients were divided into three groups through the application of Warfarin Sodium and low molecular dextran after PSE.There were 257 patients in group A without drug intervention after PSE.There were 389 patients in group B with Warfarin Sodium on the same day of PSE.There were 523 patients in group C with low molecular dextran on the same day of PSE.The incidence rate of PVT was compared among the three groups.Results The number of PVT occur was 30 cases(11.7%)in group A,27 cases(6.9%)in group B and 31 cases(5.9%)in group C.The difference of the incidence rate of the PVT among three groups were significant between group A and group B(χ^(2)=4.308,P=0.038)、group C(χ^(2)=7.892,P=0.005)and was not significant between group B and group C(χ^(2)=0.385,P=0.535).The account of platelet、prothrombin time in 7th day after PSE were not significant different among the three groups.Conclusion The application of drug intervention in the early period can prevent the formation of the PVT in patients with hypersplenism after PSE.

关 键 词：肝硬化 部分脾动脉栓塞术 门静脉血栓形成 

分 类 号：R575.2[医药卫生—消化系统]