门静脉高压症术后门静脉血栓形成的危险因素分析

Analysis on the risk factors of portal vein thrombosis after the operation in patients with portal hypertension

摘要:

目的：探讨门静脉高压症术后门静血栓形成(Portal vein thrombosis，PVT)的危险因素。方法：回顾性分析我院2006年1月至2010年12月行门体断流术的153例肝硬化门静脉高压症患者的临床资料，所有患者根据门静脉是否形成血栓分为两组，对患者年龄、性别、术前有无呕血、手术时间、术中失血量、门静脉直径、术前及术后门静脉血流速度、血小板计数、凝血酶原时间等相关因素进行单因素分析及多因素Logistic回归分析。结果：门静脉高压症患者术后PVT率为18.30%(28/153)，与无血栓组比较，血栓组患者术中失血量明显多于无血栓组(P＜0.05)，门静脉直径增宽明显(P＜0.05)，门静脉血流速度显著下降(P＜0.05)，血小板计数显著增多(P＜0.05)。多因素分析显示门静脉直径、术后门静脉血流速度是PVT的独立危险因素。结论：门静脉直径增宽和门静脉血流速度降低是门体断流术后PVT的主要原因。

Abstract:

Objective:To discuss the risk factors of portal vein thrombosis (PVT) after the operation in patients with portal hypertension.Methods：The clinical data of 153 cases of hepatic cirrhosis complicated with portal hypertension receiving disconnection from January 2006 to December 2010 in our hospital were retrospectively analyzed.All cases were divided into two groups according to formation of portal vein thrombosis.Single factor analysis and Logistic regression analysis were applied to analyze the risk factors such as age,sex,having hematemesis or not before the operation,operation time,intraoperative blood loss volume,diameter of the portal vein,blood flow speed of the portal vein,blood platelet count and prothrombin time.Results：The formation rate of PVT was 18.30%(28/153).The diameter of the portal vein was widened significantly,blood flow speed of the portal vein was descended obviously and blood platelet count was increased remarkably in the portal vein thrombosis group compared with those in the non portal vein thrombosis group (P<0.05).Logistic regression analysis indicated that the diameter of the portal vein and the postoperative blood flow speed of the portal vein were the independent risk factors of PVT after the operation.Conclusion：The widening of the protal vein diameter and the descending of the portal vein flow speed are the main causes of PVT after the operation of disconnection.