CAJ | 학술논문

目的：探讨肝硬化门静脉高压症断流术后门静脉系统血栓的发生情况及其防治。方法回顾性分析113例肝硬化门静脉高压症断流术后患者的临床资料，患者肝硬化均由晚期血吸虫病和乙肝导致，分析其术后门静脉系统血栓形成的时间、部位，并探讨预防和治疗方法。结果113例患者中，33例断流术后门静脉系统血栓形成，血栓形成发生率为29.2%。血栓形成时间为术后2～15 d，中位时间为术后6 d；单纯脾静脉和门静脉血栓各19例和10例，另4例脾静脉和门静脉均有血栓形成。经溶栓治疗后，30例血栓消失。结论多数患者断流术后门静脉系统血栓形成位于脾静脉。术中避免钳夹脾静脉主干、术后早期采取全身抗凝治疗能有效预防血栓形成。
목적：탐토간경화문정맥고압증단류술후문정맥계통혈전적발생정황급기방치。방법회고성분석113례간경화문정맥고압증단류술후환자적림상자료，환자간경화균유만기혈흡충병화을간도치，분석기술후문정맥계통혈전형성적시간、부위，병탐토예방화치료방법。결과113례환자중，33례단류술후문정맥계통혈전형성，혈전형성발생솔위29.2%。혈전형성시간위술후2～15 d，중위시간위술후6 d；단순비정맥화문정맥혈전각19례화10례，령4례비정맥화문정맥균유혈전형성。경용전치료후，30례혈전소실。결론다수환자단류술후문정맥계통혈전형성위우비정맥。술중피면겸협비정맥주간、술후조기채취전신항응치료능유효예방혈전형성。
Objective To discuss the occurrence of thrombosis in portal system of patients with cirrhotic portal hypertension after devascularization and the methods for treatment and prevention. Methods The clinical data of 113 patients with cirrhotic portal hypertension after the devascularization were collected and analyzed retrospectively and the occurrence time parts as well as the treatment and prevention methods were discussed. Results Among the 113 patients 33 of them were found with thrombosis in their portal system and the occurrence rate was 29.2%. The occurrence time of thrombosis was 2?15 days post?de?vascularization and the median time was 6 days post?operation. Among the 33 cases with thrombosis there were 19 cases of splenic vein thrombosis 10 cases of portal thrombosis and 4 cases of both of them. After the thrombolytic therapy the thrombo?sises in 30 cases disappeared. Conclusions Most of the thrombosises in portal system happen in splenic vein post?devascular?ization. Avoiding clamping the trunk of splenic vein in the operation and taking thrombolytic therapy at the early stage after the operation can effectively prevent the occurrence of thrombosis.