CAJ | 학술논문

目的探讨采用华法林防治改良的腹腔镜下脾切除治疗门静脉高压术后门静脉系统血栓形成的可行性、安全性及其近期疗效. 方法回顾性分析2014年l-8月扬州大学临床医学院收治的21例肝硬化性门静脉高压伴脾亢患者的临床资料.根据患者术后接受的不同治疗方案分为两组:华法林组(10例)和阿司匹林组(11例),比较两组患者术后门静脉系统血栓的情况.结果术后第1周所有患者总的门静脉系统血栓发生率为48％(10/21).华法林组术后第3个月总的门静脉系统血栓发生率低于阿司匹林组(1/l0比7/11,P=0.024),华法林组术后第3个月门静脉主干血栓的发生率低于阿司匹林组(0比6/11,P=0.012).两组无l例患者在围手术期出现消化道出血或死亡.结论华法林防治改良的腹腔镜脾切除治疗门静脉高压症脾亢术后的门静脉系统血栓是安全可行的,且疗效确切.
목적 탐토채용화법림방치개량적복강경하비절제치료문정맥고압술후문정맥계통혈전형성적가행성、안전성급기근기료효. 방법 회고성분석2014년l-8월양주대학림상의학원수치적21례간경화성문정맥고압반비항환자적림상자료.근거환자술후접수적불동치료방안분위량조:화법림조(10례)화아사필림조(11례),비교량조환자술후문정맥계통혈전적정황.결과술후제1주소유환자총적문정맥계통혈전발생솔위48％(10/21).화법림조술후제3개월총적문정맥계통혈전발생솔저우아사필림조(1/l0비7/11,P=0.024),화법림조술후제3개월문정맥주간혈전적발생솔저우아사필림조(0비6/11,P=0.012).량조무l례환자재위수술기출현소화도출혈혹사망.결론 화법림방치개량적복강경비절제치료문정맥고압증비항술후적문정맥계통혈전시안전가행적,차료효학절.
Objective To investigate the feasibility and safety,and short-term therapeutic effect of warfarin preventing portal vein thrombosis in liver cirrhotic patients after modified laparoscopic splenectomy.Methods A total of 21 admitted cirrhotic patients with hypersplenism undergoing modified laparoscopic splenectomy between January 2014 and August 2014 were retrospectively reviewed.Patients were divided into warfarin group (n =10) and aspirin group (n =11).Post-operative clinical parameters of portal vein thrombosis were analyzed and compared between the two groups.Results The overall incidence of portal vein thrombosis in the first week after operation is 48％ (10/21).On the third month the incidence (1/10 vs.7/11,P =0.024) of portal vein thrombosis after operation in warfarin group was lower than those in aspirin group.The incidence of main portal vein thrombosis in warfarin group was lower than that in aspirin group (0 vs.6/11,P =0.012).There were not upper gastrointestinal hemorrhage or death in either groups during perioperative period.Conclusions It is safe,feasible and with good therapeutic effect for warfarin to prevent portal vein thrombosis in cirrhotic patients after modified laparoscopic splenectomy.