【摘要】 目的探讨门静脉高压症脾切断流术后门静脉系血栓形成的易患因素及预测PVT的可能。方法自2003～2005年我院收治门静脉高压症行脾切断流术患者82例,其中37例未行祛聚抗凝治疗的患者纳入研究对象。对患者年龄、性别、门静脉直径、门静脉血流流速的变化、血小板数值等相关指标监测分析,评估门静脉高压症患者脾切断流术后PVT的易患因素。借助Logistic回归模型尝试预测术后PVT的概率。结果术后PVT患者9例(9/37,24.3%)。PVT患者的平均年龄大于无PVT患者(P<0.05),门静脉血流流速在PVT患者中明显减缓(P<0.05),PVT患者的平均门静脉直径较无PVT患者增宽,但尚未显示出统计学上的差异(t=1.845,P=0.074)。患者的性别、凝血酶原时间、血小板数值升高等在PVT与无PVT的患者间无明显差异(P>0.05)。每例患者术后PVT的总的预测正确率为89.2%。结论患者年龄增大,门静脉血流流速减缓是PVT的易患因素。通过患者年龄、门静脉直径及门静脉血流流速预测PVT是可行的。更多还原

【Abstract】 Objective To investigate the risky factor,and the predictability of portal vein thrombsis in patients with portal hypertension treated by spleenectomy and esophageal devascularization. Methods Spleenectomy and esophageal devascularization were performed in 82 patients with portal hypertension. Among them 37 patients without anti-coagulation treatment were included in this study. The data of patients about age,sex were collected to be analyzed,the level of platform was examined,and the diameter and the blood flow of portal vein were measured by Doppler ultrasonography. Results PVT occurred after operation in 9 of 37 patients(9/37,24.3%). The age of the patients with PVT was elder than that of those without PVT(P < 0.05),and the blood flow of the portal vein in patients with PVT was slower than that in those without PVT(P < 0.05). Although there was no significant statistic differences in the two groups of patients with or without PVT ,it suggested that the diameter of the portal vein of the patients with PVT increased more than that of those without PVT(t = 1.845,P = 0.074). There were no significant differences of the sex,prothrombin time and platlet counting in the two groups of patients with or without PVT(P > 0.05). The probability value of PVT could be acquired by analyzing parameters about the age of patients,the diameter and the blood flow of portal vein with logistic regression. The right predictive rate of PVT was 89.2%. Conclusion The risk factors of PVT are elder age,and the alleviation of the blood flow of portal vein . It is probable that predicting PVT pre-operatively with the data of the age,the diameter and the blood flow of portal vein.更多还原