经脾静脉置管预防脾切除断流术后早期门静脉血栓

目的 评价经脾静脉置管抗凝治疗对脾切除断流术后门静脉血栓形成的预防效果及安全性.方法 60例择期行脾切除断流术的门脉高压上消化道出血患者随机分为置管组和对照组,采用超声多普勒和（或）强化螺旋CT 扫描监测术后门静脉血栓形成情况.结果 60例患者全部随访3个月,对照组累计门静脉血栓发生率为56.7%,置管组为16.7%,两组比较,差异有统计学意义（P ＜0.05）.经脾静脉置管以200U/h的剂量输入肝素溶液对体循环静脉血凝血酶原时间和活化部分凝血活酶时间无影响.结论 断流术后经脾静脉置管抗凝治疗能有效降低门脉高压脾切除断流术后早期门静脉血栓形成,是安全可行的.

Indwelling catheter via splenic vein to prevent early portal vein thrombosis after splenectomy and esophagogastric devascularization

Objective To evaluate the efficacy and safety of early anticoagulation via splenic vein inpreventing portal vein thrombosis after splenectomy and esophagogastric devascularization. Methods The 60 patients treated with splenectomy and esophagogastric devascularization were randomized into two groups：indwelling catheter group and control group. Doppler ultrasound and/or CT were used for diagnosis of PVT. Results All cases had finished investigation for three months.In control group,the total PVT rate within 3 months was 56.7% and in indwelling catheter group was 16.7%. PVT rate was significantly reduced in indwelling catheter group in contrast with control group（P 〈 0.05）. Heparin infusion of 200 U/h through spleen vein had no side-effect. Conclusion Infusion of heparin through indwelling catheter of splenic vein is effective and safe in preventing early PVT after splenectomy and esophagogastric devascularization.