预防性使用低分子肝素钠对断流术后门静脉血栓的疗效观察

田东

（陕西省平利县医院普外科，陕西 安康，725500）

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摘要：

目的 探讨预防性使用低分子肝素钠对门静脉高压症患者断流术后门静脉血栓的临床效果。方法 选取我院收治的肝硬化门静脉高压患者55例，随机分为治疗组（n=27）和对照组（n=28）。所有患者均行全麻下脾切除贲门周围血管离断手术，术后给予常规抗感染、保肝治疗。观察组患者在此基础上加用低分子肝素钠治疗。比较两组患者的临床效果。结果 两组患者手术后 血小板计数均逐渐升高（P<0.05）；两组患者术后3、7、14天血小板计数组间比较，差异无统计学意义（P>0.05）。术后3、7天，两组患者的APTT水平明显低于术前（P<0.05）；两组患者的PT、APTT 水平比较，差异无统计学意义（P>0.05）。治疗组患者术后门静脉系统血栓发生率为7.4%，明显低于对照组的21.4%（P<0.05）。两组患者腹腔引流量及不良反应发生情况比较，差异无统计学意义（P>0.05）。结论 断流术后预防性使用低分子肝素钠可以有效预防门静脉血栓形成，值得临床推广。

关键词：门静脉高压症；门静脉血栓；低分子肝素钠

中图分类号：R657.34文献标志码：A文章编号：2096-1413(2017)16-0050-02

Effect observation of preventive low molecular wight heparin sodium in the postoperative portal vein thrombosis

of cirrhosis and portal hypertension
TIAN Dong
(Department of General Surgery, Pingli County Hospital, Ankang 725500, China)

ABSTRACT: Objective To investigate the effect of preventive low molecular weight heparin sodium in the postoperative portal vein thrombosis of cirrhosis and portal hypertension. Methods Fifty-five cases of patients with portal hypertension treated in our hospital were selected and randomly divided into treatment group (n=27) and control group (n=28). All the patients were treated with conventional anti -infection and liver treatment after splenectomy and pericardial devascularization under general anesthesia. The observation group received low molecular weight heparin sodium on the basis of the routine therapy. The clinical effects of the two groups were compared. Results The platelet count increased gradually after operation in the two groups (P<0.05). There were no significant differences on platelet count at 3, 7 and 14 days after operation between the two groups (P>0.05). At 3 and 7 days after operation, the levels of APTT were lower than those before operation (P<0.05); and there were no significant differences on the levels of PT and APTT between the two groups (P>0.05). The incidence rate of postoperative portal vein thrombosis of the treatment group was 7.4%, which was lower than 21.4% of the control group (P<0.05). There was no significant difference on the volume of drainage and adverse reactions between two groups (P>0.05). Conclusion The application of postoperative low molecular weight heparin sodium in the cirrhosis and hypertension can effectively prevent portal vein thrombosis, which is worthy of clinical application.

KEYWORDS: portal hypertension; portal vein thrombosis; low molecular weight heparin sodium

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