摘要
[目的]探究在失代偿期肝硬化患者中应用低分子肝素对于门静脉血栓(PVT)的预防作用及安全性。[方法]选择2016年6月～2017年5月间我院收治的96例失代偿期肝硬化患者,随机数表法分为对照组和试验组(每组48例),均给予常规治疗,此外对照组给予阿司匹林治疗,试验组给予低分子肝素治疗,2组患者均治疗12个月并随访。比较2组患者治疗前后的肝功能指标、凝血功能指标、门静脉系统指标,及治疗随访期间2组患者的不良反应情况、累计上消化道出血发生情况、PVT发生情况和总生存率。[结果]治疗前,2组间的肝功能指标、凝血功能指标和门静脉系统指标差异均无统计学意义;治疗后,2组上述各项指标均较治疗前明显改善(P<0.05);其中,试验组的肝功能指标中TBIL水平低于对照组,ALB水平高于对照组(均P<0.05),2组的凝血功能各指标差异无统计学意义,门静脉系统各指标水平均高于对照组(均P<0.05)。试验组和对照组3级及以上不良反应发生率分别为14.58%和10.41%,差异无统计学意义(P=0.757),试验组患者的上消化道出血发生风险明显低于对照组(HR=0.281,95%CI[0.0945,0.833],P=0.040),试验组患者的PVT发生风险明显低于对照组(HR=0.272,95%CI[0.105,0.705],P=0.014),试验组患者的死亡风险明显低于对照组(HR=0.327,95%CI[0.142,0.757],P=0.013)。[结论]低分子肝素能改善失代偿期肝硬化患者的肝功能和凝血功能,可有效预防PVT的发生。
[Objective]To explore the prevention and safety of portal vein thrombosis(PVT)by low molecule heparin in decompensated cirrhosis patients.[Methods]96 patients with decompensated cirrhosis admitted to our hospital from June 2016 to May 2017 were selected.They were divided into control group and experimental group by random number table method(48 cases in each group).All patients were given conventional treatment.In addition,the control group was given aspirin treatment,the experimental group was given low molecular weight heparin treatment.Both groups were treated for 12 months and follow-up.The liver function,coagulation function,portal vein system,adverse reactions,cumulative upper gastrointestinal bleeding,PVT and overall survival rate were compared between the two groups before and after treatment.[Results]There was no significant difference in liver function,coagulation function and portal vein system between the two groups before treatment.After treatment,the above indexes of the two groups were significantly improved(P<0.05).The levels of TBIL and ALB in the experimental group were significantly reduced(P <0.05).There was no significant difference in coagulation function between the twogroups.The levels of portal vein system indexes were higher than those of the control group(P<0.05).The incidence of grade 3 and above adverse reactions in the experimental group and the control group were14.58% and 10.41%,respectively.There was no significant difference between the two groups(P =0.757).The risk of upper gastrointestinal bleeding in the experimental group was significantly lower than that in the control group(HR=0.281,95%CI[0.0945,0.833],P=0.040).The risk of P VT in the experimental group was significantly lower than that in the control group(HR=0.272,95%CI[0.105,0.705],P=0.014).The risk of death in the experimental group was significantly lower than that in the control group(HR=0.327,95%CI[0.142,0.757],P=0.013).[Conclusion]Low molecule heparin can improve the liver function and coagulation function of patien
作者
胡丽华
曹世敏
李春柱
HU Li-hua;CAO Shi-min;LI Chun-zhu(Department of Infectious Disease,Urumqi Friendship Hospital,Urumqi 830000,China)
出处
《中国中西医结合消化杂志》
CAS
2018年第12期1023-1028,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
新疆维吾尔自治区自然科学基金项目(No:2016D01C278)
关键词
低分子肝素
失代偿期肝硬化
门静脉血栓
预防
安全性
low molecular heparin
decompensated cirrhosis
portal vein thrombosis
prevention
safety
