Hongwei Chen, Zhang Liang, Maoping Li, Yong Zhang, Chengyou Du, Dewei Li
Hepatogastroenterology. 2015 Mar-Apr;62(138):405-9.
BACKGROUND/AIMS: Portal vein thrombosis (PVT) is a common complication following splenectomy in patients with liver cirrhosis and portal hypertension, which also brings difficulties to future possible liver transplantation. This paper retrospectively analyzes the preventive effect of combined anatomic splenectomy and early anticoagulant therapy on post-splenectomy portal vein thrombosis in patients with portal hypertension.
We retrospectively analyzed 136 patients who underwent splenectomy at our hospital between January 2010 and December 2013 due to liver cirrhosis and portal hypertension. Patient conditions, such as coagulation function, splenic and portal vein thrombosis, intra-abdominal hemorrhage, pancreatic leakage and intra-abdominal infections, are observed postoperatively.
Despite the presence of liver cirrhosis and portal hypertension in patients, early postoperative anticoagulant therapy has no significant impact on coagulation function and intra-abdominal hemorrhage of these patients (p > 0.05). Anatomic splenectomy can reduce the occurrence of complications such as postoperative bleeding, pancreatic leakage and intra-abdominal infections (p < 0.05).
Combined anatomic splenectomy and early postoperative anticoagulant therapy can reduce post-splenectomy portal vein thrombosis in patients with portal hypertension, and is conducive to the future liver transplantation therapy may be needed by the patients.
背景/目的：门静脉血栓形成（PVT）是肝硬化和门静脉高压患者脾切除术后的常见并发症，这也给未来可能需要的肝移植带来困难。本文回顾性分析解剖性脾切除术联合早期抗凝治疗对门静脉高压患者脾切除术后门静脉血栓形成的预防效果。
我们回顾性分析了2010年1月至2013年12月期间在我院因肝硬化和门静脉高压接受脾切除术的136例患者。术后观察患者的凝血功能、脾静脉和门静脉血栓形成、腹腔内出血、胰漏和腹腔内感染等情况。
尽管患者存在肝硬化和门静脉高压，但术后早期抗凝治疗对这些患者的凝血功能和腹腔内出血无显著影响（p>0.05）。解剖性脾切除术可减少术后出血、胰漏和腹腔内感染等并发症的发生（p<0.05）。
解剖性脾切除术联合术后早期抗凝治疗可减少门静脉高压患者脾切除术后门静脉血栓形成，有利于患者未来可能需要的肝移植治疗。
