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分析肝切除术后门静脉血栓形成的相关影响因素。

Analysis of Related Influencing Factors of Portal Vein Thrombosis After Hepatectomy.

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2024 Mar;34(3):246-250. doi: 10.1089/lap.2023.0455. Epub 2024 Jan 22.

DOI:10.1089/lap.2023.0455
PMID:38252557
Abstract

To analyze the related factors of portal vein thrombosis (PVT) after hepatectomy. A retrospective analysis was made on 1029 patients who underwent partial hepatectomy in the first affiliated Hospital of Chongqing Medical University from March 2018 to March 2023, including PVT group ( = 24) and non-PVT group ( = 1005). The general and clinical data of the two groups were collected. Univariate and multivariate logistic regression analysis was used to analyze the clinical information of the two groups. The proportion of preoperative hepatitis B, liver cirrhosis, ascites, intraoperative blood transfusion, postoperative hemostatic drugs, preoperative prothrombin time, intraoperative portal occlusion time, operation time, international standardized ratio of prothrombin time on the first day after operation, D-dimer on the first day after operation, fibrin degradation products on the first day after operation and postoperative hospital stay in the PVT group were all higher than those in the control group ( < .05). The preoperative platelet and albumin in the PVT group were lower than those in the control group. Intraoperative blood transfusion, liver cirrhosis, ascites, international standardized ratio of postoperative prothrombin time, postoperative fibrin degradation products, hilar occlusion time and albumin were independent risk factors for PVT. There are many influencing factors of PVT after hepatectomy. Clinical intervention should be taken to reduce PVT. Clinical Registration Number: K2023-348.

摘要

分析肝切除术后门静脉血栓形成(PVT)的相关因素。对 2018 年 3 月至 2023 年 3 月在重庆医科大学第一附属医院行部分肝切除术的 1029 例患者进行回顾性分析,包括 PVT 组(n=24)和非 PVT 组(n=1005)。收集两组的一般和临床资料。采用单因素和多因素 logistic 回归分析两组的临床信息。PVT 组术前乙型肝炎、肝硬化、腹水、术中输血、术后止血药物、术前凝血酶原时间、术中门静脉阻断时间、手术时间、术后第 1 天凝血酶原时间国际标准化比值、术后第 1 天 D-二聚体、术后第 1 天纤维蛋白降解产物、术后住院时间的比例均高于对照组(P<0.05)。PVT 组术前血小板和白蛋白低于对照组。术中输血、肝硬化、腹水、术后凝血酶原时间国际标准化比值、术后纤维蛋白降解产物、肝门阻断时间和白蛋白是 PVT 的独立危险因素。肝切除术后 PVT 的影响因素较多,应采取临床干预措施减少 PVT。临床注册号:K2023-348。

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