抗凝祛聚法在选择性贲门周围血管离断术后预防门静脉血栓形成中的临床应用

摘要

目的:评价分析抗凝祛聚法在选择性贲门周围血管离断术后预防门静脉血栓形成中的临床疗效及安全性.方法:将我院2006年5月-2010年5月因肝炎后肝硬化门静脉高压症拟施行选择性贲门周围血管离断术的88例患者随机分为2组:抗凝组47例(早期使用抗凝祛聚法)与非抗凝组41例(同期常规使用药物组)进行对比分析,并利用彩色多普勒超声监测门静脉血栓形成情况.结果:88例患者均随访6个月以上,抗凝组术后门静脉血栓发生率为4.2%(2/47),明显低于非抗凝组的14.6%(6/41),差异有统计学意义(X2=3.38,P<0.05).术后1周2组间血小板(PLT)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶原时间(APPT)、纤维蛋白原(FIB)比较差异无统计学意义(P>0.05).结论:选择性贲门周围血管离断术后早期抗凝祛聚治疗能安全有效地降低门静脉血栓的发生率.%Objective: To evaluate the efficacy and safety of early anticoagulation therapy in preventing portal vein thrombosis (PVT) in patients after selective pericardial devascularization. Methods: Clinical data of 88 cases with portal hypertension received selective pericardial devascularization were retrospectively analyzed from May 2006 to May 2010. All patients were randomized into two groups after operation: 47 cases with early anticoagulation therapy and 41 cases with conventional treatment. Early anticoagulation therapy was compared with conventional treatment. Color Doppler ultrasonography was used for diagnosis. Results: All patients had finished investigation for 6 months.The incidence rate of PVT in early anticoagulation therapy group was 4.2％ (2/47), and more significantly reduced than 14.6％ (6/41) of PVT rate in conventional treatment group(x2=3.38, P＜0.05). Alterations on the platelet count and the indices of coagulation in both groups after one week after operation did not show any significant difference(P＞0.05). Conclusion: Early anticoagulation therapy can efficiently and safely reduce morbidity of PVT after selective pericardial devascularization.