低分子肝素钙应用时机对门静脉高压脾切除术后门静脉血栓发生的影响

doi:10.3969/j.issn.1671-7171.2018.03.015

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Abstract 【Objective】To investigate the effect of low molecular weight heparin calcium on the occurrence of portal vein thrombosis (PVT) after splenectomy in patients with portal hypertension (PH).【Methods】Sixty-six patients with PH underwent splenectomy from January2015 to December 2016 in our hospital were enrolled for the study and randomly divided into group A and group B, 33 cases in each group. Patients in the group A were treated with low-molecular-weight heparin and low molecular dextran combined anticoagulant therapy at the early postoperative stage. The group B received low-molecular-weight dextran after operation. When the platelet count (PLT) counts were more than 100×10⁹/L, low molecular weight heparin calcium was used. The incidence of PVT, hemostasis and coagulation function were compared between the two groups. The bleeding was recorded in both groups.【Results】There were 20 cases of PVT in 66 patients within 2 weeks after operation, the total incidence was 30.3%.The incidence of PVT in the group A 18.2% (6 / 66) was significantly lower than that in the group B 42.4% (14 / 66), the difference was statistically significant (P<0.05). The PLT count of the two groups on d₃、d₇、d₁₄was significantly higher than that on the d₁, the difference is statistically significant (P<0.05). The prothrombin time (PTT), activated partial thromboplastin time (APTT) and thrombin time (TTT) were in a fluctuating state. But there was no significant difference between the two groups in PLT, PT, APTT and TT, the difference was not statistically significant (P>0.05). No skin congestion, ecchymosis, hematuria, blood stool were found in all patients.【Conclusion】Early combination of low molecular weight heparin calcium and low molecular dextran can effectively prevent the formation of PVT after splenectomy in patients with PH. Its effect is superior to that of medium-term application, and it is safe and reliable. It is worth popularizing in clinic.

Key words： Calcium/PD Heparin, Low-Molecular-Weight/PD Hypertension, Portal Splenectomy Portal Vein Thrombosis

Received: 10 July 2017

PACS:

R657.34

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	Articles by authors
	JI Fu-long
	KONG Yan-xia
	SHI Pi-ye

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JI Fu-long,KONG Yan-xia,SHI Pi-ye. Effect of Low Molecular Weight Heparin Calcium on the Occurrence of Portal Vein Thrombosis (PVT) after Splenectomy in Patients with Portal Hypertension (PH)[J]. JOURNAL OF CLINICAL RESEARCH, 2018, 35(3): 467-470.

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.03.015 OR http://www.jcr.net.cn/EN/Y2018/V35/I3/467

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