抗凝治疗在门静脉高压症联合手术中的应用意义

目的探讨抗凝治疗在门静脉高压症联合手术中的应用意义。方法将67例均行联合手术的门静脉高压症患者随机分为2组。抗凝组(32例)在术后行抗凝治疗;对照组(35例)术后未行抗凝治疗。比较两组间门静脉系统血栓形成、远期上消化道再出血发生率及手术前后门静脉高压胃病的改善情况。结果抗凝组术后门静脉系统血栓形成发生率为0,明显低于对照组的20.0%(P<0.05)。对照组远期上消化道再出血发生率为30.0%,明显高于抗凝组的7.1%(P<0.05)。抗凝组与对照组比较,门静脉高压性胃病得到明显缓解。结论抗凝治疗可明显降低联合手术后门静脉系统血栓形成、远期上消化道再出血的发生率,是一种安全、有效的辅助治疗措施。

The application of anticoagulant therapy in portal hypertension after portaazygous devascularization and splenorenal shunt

Objective To investigate the clinical application of anticoagulant therapy in portal hypertension after portaazygous devascularization and splenorenal shunt. Methods In this randomized control study 67 patients with portal hypertension were treated with combined portaazygous devascularization and splenorenal shunt operation. In anticoagulant group, 32 patients were treated by heparins after operation, and in control group 35 patients were not treated by heparins. The incidence rate of portal vein thrombus, the long-term recurrent bleeding after operation and portal hypertensive gastropathy (PHG) were compared between two groups. Results The incidence rate of portal vein thrombus after combined operation in anticoagulant group was significantly lower than that of control group (0/32 vs 7/35, P<0.05). The rate of long-period recurrent bleeding in control group was significantly higher than that in anticoagulant group (30% vs 7.1%, P<0.05). The portal hypertensive gastropathy in anticoagulant group was improved more significantly than contrast group. Conclusion Anticoagulant therapy can reduce the incidence rate of portal vein thrombus and the long-term recurrent bleeding in portal hypertension after combined ortaazygous devascularization and splenorenal shunt operation.