乙型肝炎肝硬化患者脾切除断流术后门静脉血栓形成的相关因素分析  

Related Factors of Portal Vein Thrombosis after Splenectomy and Devascularization in Patients with Hepatitis B Cirrhosis

作　　者：阮英俊 张银科 RUAN Ying-jun;ZHANG Yin-ke(Department of general surgery,Ankang Hospital of traditional Chinese medicine,Ankang,725000,China;Department of Emergency,Baoji Hospital of Traditional Chinese medicine,Baoji,721001,China)

机构地区：[1]安康市中医医院普外科,安康725000 [2]宝鸡市中医医院急诊科,宝鸡721001

出　　处：《血栓与止血学》2022年第3期376-378,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨乙型肝炎肝硬化患者脾切除断流术后门静脉血栓(PVT)形成因素。方法以100例乙型肝炎肝硬化患者为对象,记录患者脾切除断流术后发生PVT的例数,并分析影响患者并发PVT的危险因素。结果100例乙型肝炎肝硬化患者中脾切除断流术后20例并发PVT。PVT组与非PVT组在血小板计数(PLT)、胆碱酯酶(CHE)、谷草转氨酶(GOT)、凝血酶时间(TT)、脾脏厚度、门静脉内径、脾静脉内径、肝硬化家族史、Child-Pugh分级方面比较差异显著(P<0.05)。Logistic回归分析,结果显示Child-Pugh分级(OR=2.887)、PLT(OR=1.015)、门静脉内径(OR=121.341)为影响患者并发PVT的独立危险因素(P<0.05)。结论Child-Pugh分级C级、PLT升高、门静脉内径升高是乙型肝炎肝硬化患者脾切除断流术后并发PVT的独立危险因素,对于高危人群应给予针对性的干预。Objective To investigate the factors of portal vein thrombosis(PVT)after splenectomy and devascularization in patients with hepatitis B cirrhosis.Methods 100 patients with hepatitis B cirrhosis were enrolled in this study.The incidence of PVT after splenectomy and devascularization was recorded,and the risk factors of PVT were analyzed.Results The mong 100 cases of hepatitis B cirrhosis,20 cases were complicated with PVT after splenectomy and devascularization.There were significant differences in platelet count(PLT),cholinesterase(CHE),glutamic oxaloacetic transaminase(GOT),thrombin time(TT),spleen thickness,portal vein diameter,splenic vein diameter,family history of liver cirrhosis and child Pugh grade between PVT group and non PVT group(P<0.05).Logistic regression analysis showed that child Pugh grade(OR=2.887),PLT(OR=1.015)and portal vein diameter(OR=121.341)were independent risk factors for PVT(P<0.05).Conclusion Child Pugh grade C,increased PLT and portal vein diameter are independent risk factors of PVT in patients with hepatitis B cirrhosis after splenectomy and devascularization.Targeted nursing intervention should be given to high-risk groups.

关 键 词：乙型肝炎肝硬化 门静脉血栓 脾切除断流术 

分 类 号：R575.2[医药卫生—消化系统]