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门脉高压脾切除或加断流术后门脉血栓形成与门脉压力的关系

邢谦哲1,王毅军2,杜智1,袁强2   

  1. 1. 天津市第三中心医院
    2.
  • 收稿日期:2009-08-21 修回日期:2010-01-11 出版日期:2010-07-15 发布日期:2010-07-15
  • 通讯作者: 邢谦哲

The relationship between portal vein pressure and portal vein thrombosis in patients after splenectomy for portal hypertension

  • Received:2009-08-21 Revised:2010-01-11 Published:2010-07-15 Online:2010-07-15
  • Contact: XING Qian Zhe

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摘要： 【 摘要】 目的： 分析肝炎肝硬化门静脉高压症脾切除术后门静脉系统血栓形成与术前门静脉压力及术前术后门静脉压力下降水平是否相关。方法： 回顾性分析我院2000年8月至2 0 0 7 年 6月收治的肝炎肝硬化门静脉高压症行脾切除或脾切除加断流术的病人 226人，有效样本数154例，根据是否形成血栓将病例分为门静脉系统血栓形成组及无血栓形成组两组。分别采用t检验与秩和检验分析术前门静脉压力及术前术后门静脉压力下降水平在两组之间有无差别；另外根据门静脉压力下降水平将病例分为≤8 cmH2O和>8 cmH2O组，应用X2检验对两组门静脉血栓形成率进行比较。结果： 在154例病人中，门静脉系统血栓形成31例，123例无血栓形成。统计分析显示门静脉系统的血栓形成与术前门静脉压力及术前术后门静脉压力下降水平有关（P<0.05）；门静脉压力下降水平>8cmH2O组血栓形成率高于门静脉压力下降水平≤8cmH2O组。结论：术前门静脉压力及术前术后门静脉压力下降水平是影响门脉高压脾切除术后门脉系统血栓形成的重要因素，术后门静脉压力下降越多，则门静脉系统血栓形成几率越高。

关键词: 门静脉高压, 门静脉血栓, 门静脉压力, 脾切除术

Abstract: Abstract Objective: To analyze if there are relationships between the portal vein pressure preoperation(PVP)/descendent level of portal vein pressure postoperation(DPVP) and portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis. Methods: The clinical data of 226 patients with hypertension due to cirrhosis resulting from hepatitis receiving simple splenectomy or splenectomy and portal-azygous devascularization in our hospital from August 2000 to June 2007 were retrospectively analyzed. The effective cases were 154. the cases were divided into 2 groups according to with or without portal vein thrombosis, relation of portal vein thrombosis to PVP and DPVP was analyzed. Accord to the DPVP, the cases were divided into ≤8cmH2O and >8cmH2O 2 groups, and we analyzed the rate of portal vein thrombosis between the 2 groups. Average comprision was studied by student-t test or nonparametric test, rate comprision was studied by chi-square test. Results: The portal vein thrombosis occurred in 31 patients and 123 patients had no thrombosis occurred. Our analysis showed that the PVP of the group with thrombosis was higher than the group without thrombosis, the DPVP of the group with thrombosis was higher than the group without thrombosis(P<0.05). The rate of thrombosis occurrence in the DPVP>8cmH2O group was greater than in the DPVP≤8cmH2O group. Conclusion: The PVP and the DPVP are important factors to portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis. The higher the DPVP was, the greater odds of the portal vein thrombosis occur.

Key words: Portal hypertension, Portal vein thrombosis, portal vein pressure, Splenectomy