CAJ | 학술논문

目的：探讨术中脾静脉置管预防脾切除术后门静脉血栓形成的安全性和有效性。方法自2010年3月至2013年1月，对我院收治的需行脾切除的120例患者随机分为2组，治疗组60例，对照组60例。治疗组脾切除后，术中脾静脉置入硬膜外导管，并经腹膜后经侧腹壁引出，术后经该导管泵入肝素盐水预防门静脉血栓形成。对照组应用常规脾切除，术后监测血小板变化，血小板超过正常，开始服用阿司匹林，潘生丁，并输注低分子右旋糖酐，预防门静脉血栓形成。比较两组手术时间，术中出血量，门静脉血栓发生率，住院时间。结果治疗组与对照组手术时间比较无显著性差异（P>0.05），治疗组门静脉血栓发生率低于对照组，差异均有显著性（P <0.05），治疗组手术死亡率较对照组降低，异有显著性（P <0.05）。结论术中脾静脉置管可以有效预防脾切除术后门静脉血栓形成，缩短住院时间，降低手术死亡率。
목적：탐토술중비정맥치관예방비절제술후문정맥혈전형성적안전성화유효성。방법자2010년3월지2013년1월，대아원수치적수행비절제적120례환자수궤분위2조，치료조60례，대조조60례。치료조비절제후，술중비정맥치입경막외도관，병경복막후경측복벽인출，술후경해도관빙입간소염수예방문정맥혈전형성。대조조응용상규비절제，술후감측혈소판변화，혈소판초과정상，개시복용아사필림，반생정，병수주저분자우선당항，예방문정맥혈전형성。비교량조수술시간，술중출혈량，문정맥혈전발생솔，주원시간。결과치료조여대조조수술시간비교무현저성차이（P>0.05），치료조문정맥혈전발생솔저우대조조，차이균유현저성（P <0.05），치료조수술사망솔교대조조강저，이유현저성（P <0.05）。결론술중비정맥치관가이유효예방비절제술후문정맥혈전형성，축단주원시간，강저수술사망솔。
Objective to investigate the operative splenicvein catheter safety and effectiveness in preventing portal vein thrombosis after splenectomy. Methods from 2010March to 2013 January, were randomly divided 120 patients admitted to our hospital for splenectomy into 2 groups, 60 cases in the treatment group, 60 cases in the control group. the treatment group after splenectomy,splenic venous epidural catheterization, and retroperitonealthrough lateral abdominal wall leads, after the catheter pump into heparinized saline to prevent portal vein thrombosis. the control group used routine splenectomy,platelet chan ge monitoring after operation, platelet than normal, start taking aspirin, Pan shengding, and the infusion of low molecular dextran, prevention of portal vein thrombosis. Between the two groups in operation time,amount of bleeding, the incidence of portal vein thrombosis, hospitalization time. Results in the treatmentgroup and the control group, operation time and there is no significant difference (P >0.05), portal vein thrombosis occurred in the treatment group was lower than that in the control group, the differences were significant (P <0.05),the treatment group operation mortality was lower than control group, there was significant difference (P <0.05).Conclusion splenic vein catheter is effective in the prevention of portal vein thrombosis after splenectomy,shorten the hospitalization time, reduce the operationmortality.