摘要
目的探讨门静脉高压症脾切除术中行脾静脉近端结扎对脾静脉源性门静脉血栓的预防效果。方法︰回顾性分析2014年8月至2019年7月宁夏回族自治区人民医院手术治疗的94例门静脉高压症患者的临床资料,其中36例行贲门周围血管离断术和脾切除联合经脾静脉冠肾静脉分流术的患者采取紧贴门静脉结扎脾静脉的方法,58例未行脾静脉结扎的贲门周围血管离断术患者作为对照组。术后均经胃网膜右静脉置入的导管滴注肝素,并于术后第7~14天行CT检查。结果脾静脉结扎组的36例患者均无门静脉血栓形成,对照组发生门静脉血栓22例(38%),脾静脉血栓58例(100%),两组门静脉血栓发生率相比差异有统计学意义(0比38%,χ^(2)=17.828,P<0.05)。结论﹐在脾切除术中结扎脾静脉近端可有效预防门静脉高压症患者术后发生脾静脉源性门静脉血栓。
Objective To evaluate the preventive effect of proximal splenic vein ligation aftersplenectomy on the splenic vein originated portal vein thrombosis(PVT)in portal hypertension.MethodsThe clinical data of 94 patients of portal hypertension who had received splenectomy were retrospectivelyanalysed.The proximal splenic vein was ligated in 36 cases during pericardial devascularization and coronaryrenal shunt with splenectomy.The other 58 cases who had received pericardial devascularization withoutproximal splenic vein ligation served as control.All of the patients in both groups were given heparin infusionpostoperatively through the catheter which was placed in the right gastroepiploic vein during operation.CTportal veinography was performed at the 7th-14th postoperative day for detection of PVT.Results None ofthe PVT occurred in the splenic vein ligation group.In the control group,PVT occurred in 22 cases(38%)and splenic vein thrombosis occurred in all the 58 cases(100%).PVT incidence between the two groups issignificantly different(0 vs.38%,χ^(2)=17.828,P<0.05).Conclusions Ligation of the proximal splenicvein during splenectomy can effectively prevent the postoperative splenic vein originated PVT in portalhypertension.
作者
田明国
李宝定
辛国军
贾东
王亚飞
Tian Mingguo;Li Baoding;Xin Guojun;Jia Dong;Wang Yafei(Department of Hepatobiliary Surgery,People's Hospital of Ningxia Autonomous Region,Yinchuan 750002,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第1期39-42,共4页
Chinese Journal of General Surgery
基金
宁夏回族自治区重大研发计划项目(宁科计字2017-33)。
