中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
12期
918-921
,共4页
邢谦哲%王毅军%袁强%杜智
邢謙哲%王毅軍%袁彊%杜智
형겸철%왕의군%원강%두지
高血压,门静脉%门静脉系统血栓%门静脉压力%脾切除术
高血壓,門靜脈%門靜脈繫統血栓%門靜脈壓力%脾切除術
고혈압,문정맥%문정맥계통혈전%문정맥압력%비절제술
Hypertension portal%Portal vein thrombosis%Portal vein pressure%Splenectomy
目的 分析肝炎肝硬化门静脉高压症病人脾切除术后门静脉系统血栓形成的相关因素.方法 我院2000年8月至2007年6月共为226例肝炎肝硬化门静脉高压症病人施行了脾切除或脾切除加断流术.本文对其中154例进行回顾性分析.根据是否形成血栓将病例分为门静脉系统血栓形成和无血栓形成两组.用Logistic回归分析术前术后门静脉压力下降水平、术前凝血酶原比值(PTR)、术前纤维蛋白原水平(FIB)、术前及术后1、7、14 d血小板水平、术前门静脉直径、术前胆红素水平、术中出血量各指标与门静脉系统血栓形成的关系.结果 在154例病人中,门静脉系统血栓形成31例,123例无血栓形成.Logistic单因素分析和多因素回归分析均显示门静脉系统血栓形成与门静脉压力下降水平有关;术前凝血酶原比值(PTR)、术前纤维蛋白原水平(FIB)、术前及术后1、7、14 d血小板水平、术前门静脉直径、术前胆红素、术中出血量水平与门静脉血栓形成无关.结论 术前、术后门静脉压力下降水平可能是影响门脉高压脾切除术后门脉系统血栓形成的重要因素,术后门静脉压力下降越多,门静脉系统血栓形成几率越高.
目的 分析肝炎肝硬化門靜脈高壓癥病人脾切除術後門靜脈繫統血栓形成的相關因素.方法 我院2000年8月至2007年6月共為226例肝炎肝硬化門靜脈高壓癥病人施行瞭脾切除或脾切除加斷流術.本文對其中154例進行迴顧性分析.根據是否形成血栓將病例分為門靜脈繫統血栓形成和無血栓形成兩組.用Logistic迴歸分析術前術後門靜脈壓力下降水平、術前凝血酶原比值(PTR)、術前纖維蛋白原水平(FIB)、術前及術後1、7、14 d血小闆水平、術前門靜脈直徑、術前膽紅素水平、術中齣血量各指標與門靜脈繫統血栓形成的關繫.結果 在154例病人中,門靜脈繫統血栓形成31例,123例無血栓形成.Logistic單因素分析和多因素迴歸分析均顯示門靜脈繫統血栓形成與門靜脈壓力下降水平有關;術前凝血酶原比值(PTR)、術前纖維蛋白原水平(FIB)、術前及術後1、7、14 d血小闆水平、術前門靜脈直徑、術前膽紅素、術中齣血量水平與門靜脈血栓形成無關.結論 術前、術後門靜脈壓力下降水平可能是影響門脈高壓脾切除術後門脈繫統血栓形成的重要因素,術後門靜脈壓力下降越多,門靜脈繫統血栓形成幾率越高.
목적 분석간염간경화문정맥고압증병인비절제술후문정맥계통혈전형성적상관인소.방법 아원2000년8월지2007년6월공위226례간염간경화문정맥고압증병인시행료비절제혹비절제가단류술.본문대기중154례진행회고성분석.근거시부형성혈전장병례분위문정맥계통혈전형성화무혈전형성량조.용Logistic회귀분석술전술후문정맥압력하강수평、술전응혈매원비치(PTR)、술전섬유단백원수평(FIB)、술전급술후1、7、14 d혈소판수평、술전문정맥직경、술전담홍소수평、술중출혈량각지표여문정맥계통혈전형성적관계.결과 재154례병인중,문정맥계통혈전형성31례,123례무혈전형성.Logistic단인소분석화다인소회귀분석균현시문정맥계통혈전형성여문정맥압력하강수평유관;술전응혈매원비치(PTR)、술전섬유단백원수평(FIB)、술전급술후1、7、14 d혈소판수평、술전문정맥직경、술전담홍소、술중출혈량수평여문정맥혈전형성무관.결론 술전、술후문정맥압력하강수평가능시영향문맥고압비절제술후문맥계통혈전형성적중요인소,술후문정맥압력하강월다,문정맥계통혈전형성궤솔월고.
Objective To analyze the relevant factors of portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis. Methods The clinical data of 226 patients with hypertension due to cirrhosis resulting from hepatitis receiving simple splenectomy or splenectomy and portal-azygous devascularization in our hospital from August 2000 to June 2007 were retrospectively analyzed. Effective results were found in 154 of the patients. The 154 cases were divided into the thrombosis group and non-thrombosis group. The relation of portal vein thrombosis to the descendent level of portal vein pressure after operation,the prothrombin ratio (PTR) and fibrinogen(FIB) before operation, platelet count before and 1, 7, 14 days after operation, diameter of main portal vein and bilirubin level before operation and blood loss in operation were determined by logistic regression analysis. Results Portal vein thrombosis occurred in 31 patients. Regression univariate analysis showed that portal vein thrombosis was related to the descendent level of portal vein pressure after operation but not to the PTR and FIB, platelet count, diameter of main portal vein, bilirubin level and blood loss. Multivariate analysis demonstrated the same results. Conclusion The descended level of portal vein pressure is an important factor in portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis.
