目的 分析肝硬化脾切除术后门静脉血栓（portal vein thrombosis，PVT）形成相关危险因素，提高围手术期的预防水平。方法 回顾性分析武汉大学人民医院2015年1月至2017年3月因肝硬化门静脉高压行脾切除术病人70例，其中术后形成PVT组18例，术后未形成PVT组52例，对其围手术期相关资料进行比较。结果 70例病人中18例出现PVT，发生率为25.7%（18/70）。PVT组与非PVT组围手术期一般资料中，PVT组手术时间为（190.1±37.7）min，明显长于非PVT组的（168.7±32.6）min（P=0.024）；PVT组脾静脉直径为（10.4±2.7）mm，明显宽于非PVT组的（9.2±1.9）mm（P=0.043）；PVT组门静脉直径为（15.1±1.8）mm，明显宽于非PVT组的（13.4±2.1）mm（P=0.024）；PVT组术后3 d的D-二聚体值为（2.47±1.32）mg/L，明显高于非PVT组的（1.83±1.10）mg/L（P=0.047）。结论 肝硬化脾切除术后PVT形成与手术时间、脾静脉直径、门静脉直径、术后3 d的D-二聚体值等因素有关，可以通过这些指标观察来预测术后PVT的形成。
Abstract
Objective To investigate the influencing factors of portal vein thrombosis (PVT) after splenectomy in patients with cirrhosis and improve the levelof perioperative prevention.Methods A retrospective study was performed on 70 cases of liver cirrhosis and portal hypertension undergoing splenectomyfrom January 2015 to March 2017 in our hospital. There were 18 cases ofPVT, and 52 cases of non-PVT.The perioperative data of PVT group and non-PVT group were compared.Results Eighteen cases developedPVT after splenectomy with the incidence of 25.7%(18/70).The operative time in the PVT group was(190.1±37.7)min, which was significantly longerthan in non-PVT group [(168.7±32.6) min, P=0.024].Splenic vein diameter in the PVT group was(10.4±2.7) mm, which was significantly wider than in non-PVT group [(9.2±1.9) mm, P=0.043].Portal vein diameter in the PVT group was (15.1±1.8) mm, which was significantly widerthan in non-PVT group [(13.4±2.1) mm, P=0.024].D-dimer level on the postoperative day 3 in the PVT group was(2.47±1.32) mg/L,which was significantly higher than in the non-PVT group [(1.83±1.10) mg/L, P=0.047].Conclusions The incidence of PVT after splenectomy in patients with cirrhosis may be associated with the diameter of splenic vein,diameter of portal vein,operative time and D-dimer level on the postoperative day 3.PVT after splenectomy can be predicted by these indicators.
关键词
肝硬化 /
脾切除 /
门静脉血栓 /
危险因素
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Key words
Liver cirrhosis /
Splenectomy /
Portal vein thrombosis /
Influencing factors
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中图分类号：
R657.6
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