早期活血、抗凝、袪聚对断流术后门静脉系统血栓形成的影响

目的探讨早期活血、抗凝、祛聚对断流术后门静脉系统血栓形成的影响。方法选取衡水市第三人民医院2006年1月～2013年12月收治的326例肝炎后肝硬化门静脉高压症并上消化道出血，并行贲门周围血管离断术患者，分为实验组（2009年2月～2013年12月收治，226例）和对照组（2006年1月～2009年1月收治，100例）。两组患者均进行贲门周围血管离断术，对照组术后常规预防性应用止血药物2～3d及术后综合治疗；实验组术中、术后不用止血药物，早期应用活血、抗凝、祛聚药物。观察两组对门静脉系统血栓形成的影响。结果实验组累计发生血栓为11例（4．42％），对照组患者累计发生血栓为35例（35．00％），两组比较差异有统计学意义（P〈0．05）。结论门静脉高压症贲门周围血管离断术后早期应用活血、抗凝、祛聚药物能明显降低血栓发生率，对围术期出血无明显影响，是防治门静脉血栓形成的安全有效的方法，有待在基层医院规范防治断流术后门静脉系统血栓形成得到推广。

Influence of activating blood and anticoagulation therapy in the earlier period on the formation of portal vein thrombosis after devascularization

Objective To explore the influence of activating blood and anticoagulation therapy in the earlier period on the formation of portal vein thrombosis after devascularization. Methods From January 2006 to December 2013, in the Third People＇s Hospital of Hengshui City, 326 hepatitis patients with cirrhotic portal hypertension and upper gastroin- testinal hemorrhage were seleted, divided into the experimental group patients （from February 2009 to December 2013, 226 cases） and the control group （from January 2006 to January 2009, 100 cases）. Both of two groups were given the splenectomy with pericardial devascularization, the control group were the conventional preventative hemostatics for 2- 3 days and comprehensive therapy; the experimental group were not given hemostasis drugs during and after surgery, but were given activating blood and anticoagulation therapy in the earlier period, the influence on the formation of por- tal vein thrombosis was observed. Results The incidence of portal vein thrombosis in the experimental group （11 cases, 4.42%） was obviously lower than that in the control group （35 cases, 35.00%）, the difference was statistically significant （P 〈 0.05）. Conclusion The application of activating blood and anticoagulation therapy in the earlier period after the portal hypertension splenectomy with pericardial devascularization surgery can obviously reduce the incidence of throm- bus, it has no apparent influence on bleeding, it is an effective method for the prevention of portal vein thrombosis, and it is worth popularizing to prevent the formation of portal vein thrombosis after devaseularization in primary hospitals.