华法林防治脾切除联合食管胃底曲张静脉断流术后门静脉血栓的近期疗效及安全性  

The Short-term Efficacy and Safety of Warfarin in Preventing and Treating Portal Vein Thrombosis after Splenectomy Combined with Esophageal Varices Devascularization

作　　者：刘勇 Liu Yong(Department of General Surgery,Xixian People's Hospital,Xinyang 464300)

机构地区：[1]息县人民医院普外科,信阳464300

出　　处：《数理医药学杂志》2022年第1期55-57,共3页Journal of Mathematical Medicine

摘　　要：目的:探究华法林防治脾切除断流术后门静脉血栓的疗效。方法:选取某院收治的肝硬化门静脉高压症患者56例,根据治疗方法分为研究组(常规治疗结合华法林抗凝治疗)和对照组(术后常规治疗,未进行华法林治疗)各28例,连续治疗1个月。统计两组治疗前后生化指标,评估患者门静脉血流速度治疗前后的变化情况,统计术后并发症。结果:治疗后两组患者血清总胆红素(TBil)降低(P<0.05),但是研究组血清肝功能指标白蛋白(ALB)及TBil水平与对照组比较,差异均无统计学意义(P>0.05)。两组治疗后门静脉直径较治疗前减小,且研究组较对照组减小显著(P<0.05),两组最大血流速度、平均血流速度显著快于治疗前,研究组快于对照组(P<0.05)。两组治疗后部分凝血活酶时间(APTT)、凝血酶原时间(PT)较治疗前延长,且研究组较对照组延长(P<0.05),两组纤维蛋白原(FIB)显著低于治疗前,且研究组低于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论:华法林可更有效地防治脾切除联合断流术后门静脉血栓(PVT)形成,改善凝血功能,且应用安全性好。Objective:To explore the efficacy of warfarin in preventing and treating portal vein thrombosis after splenectomy and devascularization.Methods:56 patients with liver cirrhosis and portal hypertension admitted to a hospital were selected and divided into study group(conventional treatment combined with warfarin anticoagulation treatment)and control group(conventional treatment after operation,no warfarin treatment)according to the treatment methods,with 28 cases in each group.The treatment was continued for 1 month.The biochemical indicators of the two groups before and after treatment were counted,the changes of the patients'portal blood flow velocity before and after treatment were evaluated,and postoperative complications were counted.Results:After treatment,the serum total bilirubin(TBil)of the two groups decreased(P<0.05),but the serum liver function indexes albumin(ALB)and TBil levels of the study group were not statistically different from those of the control group(P>0.05).After treatment,the portal vein diameter in the two groups decreased compared with before treatment,and the study group decreased significantly compared with the control group(P<0.05).The maximum blood flow velocity and average blood flow velocity in the two groups after treatment were significantly faster than those before treatment,and the study group was faster than the control group(P<0.05).After treatment,the partial thromboplastin time(APTT)and prothrombin time(PT)of the two groups were longer than those before treatment,and the study group was longer than the control group(P<0.05).The fibrinogen(FIB)of the two groups was significantly lower than that before treatment,and the study group was lower than the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:Warfarin can more effectively prevent the formation of portal vein thrombosis(PVT)after splenectomy combined with devascularization,and improve blood coagulation function,with good application

关 键 词：冠心病 高脂血症 瑞舒伐他汀 冠脉斑块 脂代谢 凝血功能 

分 类 号：R656.6[医药卫生—外科学]