Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China.
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Biomed Res Int. 2020 Aug 27;2020:9583706. doi: 10.1155/2020/9583706. eCollection 2020.
We retrospectively reviewed medical records from cirrhosis patients who underwent devascularization for the treatment of portal hypertension in our hospital between January 1, 2008, and December 20, 2014. Patients were followed up to investigate the PVT incidence at different times after surgery. Patients were divided into two groups (PVT, no PVT), and the risk factors for PVT after surgery were determined.
Until October 16, 2015, the median follow-up time of the 124 patients enrolled into this study was 41.43 months (range, 5.47-95.30 months). 61 patients had perioperative PVT, and 21 (16.94%) patients had PVT diagnosed during the follow-up period. Those who had lower preoperative white blood cell counts, larger preoperative portal vein trunk diameter, and no gastric varices were more likely to have perioperative thrombosis. In those without perioperative PVT, a history of hypertension, higher grade of splenomegaly, and higher preoperative levels of creatinine were independent predictors of PVT occurrence during the follow-up period.
The risk factors for perioperative PVT in cirrhotic patients after devascularization were lower preoperative white blood cell count and larger portal vein trunk diameter, with no gastric varices. A history of hypertension, a larger spleen, and higher preoperative creatinine level are independent predictors of PVT during follow-up after surgery in patients without perioperative PVT.
我们回顾性分析了 2008 年 1 月 1 日至 2014 年 12 月 20 日期间在我院因门静脉高压症接受断流术治疗的肝硬化患者的病历。对患者进行随访，以调查手术后不同时间的 PVT 发生率。患者分为两组（PVT 组，无 PVT 组），并确定手术后 PVT 的危险因素。
截至 2015 年 10 月 16 日，本研究纳入的 124 例患者的中位随访时间为 41.43 个月（范围：5.47-95.30 个月）。61 例患者发生围手术期 PVT，21 例（16.94%）患者在随访期间诊断为 PVT。术前白细胞计数较低、术前门静脉主干直径较大且无胃静脉曲张的患者更有可能发生围手术期血栓形成。在无围手术期 PVT 的患者中，高血压病史、脾肿大程度较高和术前肌酐水平较高是随访期间发生 PVT 的独立预测因素。
断流术后肝硬化患者围手术期 PVT 的危险因素为术前白细胞计数较低和门静脉主干直径较大，且无胃静脉曲张。无围手术期 PVT 的患者中，高血压病史、较大的脾脏和较高的术前肌酐水平是术后随访期间发生 PVT 的独立预测因素。
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