中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
5期
351-354
,共4页
前列地尔%脾切除术%离断术%门脉高压%血栓
前列地爾%脾切除術%離斷術%門脈高壓%血栓
전렬지이%비절제술%리단술%문맥고압%혈전
Alprostadil%Splenectomy%Devascularization%Portal vein hypertension%Thromb
目的 探讨应用前列地尔预防脾切除和断流术后门静脉系统血栓形成的疗效.方法 以本院2009年5月至2013年4月术后预防性应用前列地尔的113例脾切除+联合断流术患者作为治疗组,同时回顾2009年5月以前术后预防性应用传统药物的连续112例脾切除+联合断流术患者作为对照组,比较两组患者并发症发生率、手术死亡率、术后腹腔引流量、血小板计数、凝血酶原时间以及肝功能Child-Pugh评分和门静脉系统血栓形成的发生率.结果 和对照组相比,治疗组的并发症发生率和手术死亡率没有增加,腹腔引流量明显减少,血小板计数升高和凝血酶原时间延长相似,术后第3、7天肝功能损害程度也明显减轻.近期彩色多普勒超声随访显示,治疗组门静脉系统血栓发生率明显少于对照组,血栓的严重程度也减轻.结论 前列地尔是一种安全、有效的预防术后门静脉系统血栓形成的药物,可以为脾切除+断流术后全身抗凝提供一种新的选择.
目的 探討應用前列地爾預防脾切除和斷流術後門靜脈繫統血栓形成的療效.方法 以本院2009年5月至2013年4月術後預防性應用前列地爾的113例脾切除+聯閤斷流術患者作為治療組,同時迴顧2009年5月以前術後預防性應用傳統藥物的連續112例脾切除+聯閤斷流術患者作為對照組,比較兩組患者併髮癥髮生率、手術死亡率、術後腹腔引流量、血小闆計數、凝血酶原時間以及肝功能Child-Pugh評分和門靜脈繫統血栓形成的髮生率.結果 和對照組相比,治療組的併髮癥髮生率和手術死亡率沒有增加,腹腔引流量明顯減少,血小闆計數升高和凝血酶原時間延長相似,術後第3、7天肝功能損害程度也明顯減輕.近期綵色多普勒超聲隨訪顯示,治療組門靜脈繫統血栓髮生率明顯少于對照組,血栓的嚴重程度也減輕.結論 前列地爾是一種安全、有效的預防術後門靜脈繫統血栓形成的藥物,可以為脾切除+斷流術後全身抗凝提供一種新的選擇.
목적 탐토응용전렬지이예방비절제화단류술후문정맥계통혈전형성적료효.방법 이본원2009년5월지2013년4월술후예방성응용전렬지이적113례비절제+연합단류술환자작위치료조,동시회고2009년5월이전술후예방성응용전통약물적련속112례비절제+연합단류술환자작위대조조,비교량조환자병발증발생솔、수술사망솔、술후복강인류량、혈소판계수、응혈매원시간이급간공능Child-Pugh평분화문정맥계통혈전형성적발생솔.결과 화대조조상비,치료조적병발증발생솔화수술사망솔몰유증가,복강인류량명현감소,혈소판계수승고화응혈매원시간연장상사,술후제3、7천간공능손해정도야명현감경.근기채색다보륵초성수방현시,치료조문정맥계통혈전발생솔명현소우대조조,혈전적엄중정도야감경.결론 전렬지이시일충안전、유효적예방술후문정맥계통혈전형성적약물,가이위비절제+단류술후전신항응제공일충신적선택.
Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.
