Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SHANGYu-qing , ZHUHong-lin

Department of General Surgery, Ya'an Hospital of Traditional Chinese Medicine, Ya'an 625000, Sichuan Province, China;

Corresponding author：

SHANGYu-qing, Email: shangyuqing3@126.com

Keywords：

Portal vein thrombosis; Portal hypertension; Devascularization; Influence factor

DOI：

10.7507/1007-9424.20160375

Video：

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Objective To investigate the risk factors of postoperative portal vein thrombosis (PVT) after devascu-larization in patients with cirrhotic portal hypertension. Methods The clinical data of 40 patients with cirrhotic portal hypertension treated with splenectomy and gastric pericardial devascularization were retrospectively analyzed to investigate the related risk factors. Results A total of 12 of the 40 patients suffered from PVT (30.00%). The results of multivariate analysis showed that portal vein diameter, postoperative portal vein velocity, platelet count at 2 weeks postoperatively, and postoperative portal vein pressure were the factors influencing the incidence of PVT after devascularization. Patients with the greater portal vein diameter and platelet count at 2 weeks postoperatively, the lower postoperative portal vein velocity and postoperative portal vein pressure, had higher ratio of PVT (P < 0.05). Conclusion Portal vein diameter, portal vein blood flow velocity, platelet count, and postoperative portal vein pressure were the main risk factors for PVT after surgery in patients with cirrhotic portal hypertension.

Citation： SHANGYu-qing, ZHUHong-lin. Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(12): 1488-1491. doi: 10.7507/1007-9424.20160375 Copy

1.	Mercado MA, Orozco H, Ramírez-Cisneros FJ, et al. Diminished morbidity and mortality in portal hypertension surgery:relocation in the therapeutic armamentarium. J Gastrointest Surg, 2001, 5(5):499-502.
2.	张军, 邓克学.能谱CT预测肝硬化门静脉高压患者并发食管静脉曲张破裂出血风险.中国医学影像技术, 2012, 28(12):2201-2205.
3.	Zong GQ, Fei Y, Chen J, et al. Selective double disconnection for cirrhotic portal hypertension. J Surg Res, 2014, 192(2):383-389.
4.	Bureau C, Thabut D, Oberti F, et al. Transjugular intrahepatic porto-systemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology, 2016, [Epub ahead of print].
5.	Zocco MA, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis:correlation with MELD scoring system and portal vein thrombosis development. J Hepatol, 2009, 51(4):682-689.
6.	李仓, 张启瑜, 孙克龙, 等.肝癌切除联合选择性减断流术在原发性肝癌合并中重度门静脉高压症中的应用.肝胆胰外科杂志, 2015, 27(1):5-8.
7.	叶剑桥.手术治疗肝硬化门静脉高压症并发上消化道出血临床疗效分析.检验医学与临床, 2014, 11(4):514-515.
8.	余灵祥, 张绍庚, 郭晓东, 等.门静脉高压症脾切断流术后血栓形成的临床研究.现代生物医学进展, 2014, 14(20):3857-3859.
9.	Sun L, Zhou H, Gu L, et al. Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension. Int J Surg, 2015, 16(Pt A):31-35.
10.	王茂春, 李澍, 朱继业, 等.门静脉高压症外科手术后门静脉系统血栓形成的原因及防治.中国乡村医药, 2004, 11(9):269-271.
11.	王东, 栗光明, 朱继业, 等.保脾断流术治疗门静脉高压症上消化道出血的疗效分析.中国普外基础与临床杂志, 2013, 20(1):29-32.
12.	Marcus R, Peter H. Management of portal hypertension, Budd-Chiari syndrome and portal vein thrombosis. Medicine, 2015, 43(11):669-673.
13.	陈炜, 吴志勇.肝硬变门静脉高压症外科干预的时机和术式选择.中国普外基础与临床杂志, 2015, 22(11):1296-1299.
14.	Makdissi FF, Herman P, Machado MA, et al. Portal vein thrombosis after esophagogastric devascularization and splenectomy in schisto-somal portal hypertension patients:what's the real importance? Arq Gastroenterol, 2009, 46(1):50-56.
15.	杨健, 钟麟.低分子肝素钙在脾切断流术后预防门静脉血栓形成的临床观察.中国药房, 2012, 23(24):2254-2257.
16.	杨科, 杨启.肝癌切除联合断流术治疗原发性肝癌合并门静脉高压症的疗效.世界华人消化杂志, 2014, 22(19):2780-2783.
17.	李铁汉, 唐波, 唐继红, 等.脾切除术后门静脉系血栓形成的临床诊治.中国普通外科杂志, 2010, 19(12):1324-1326.
18.	肖华鑫, 王敏, 李健, 等.普萘洛尔联合5-单硝酸异山梨酯对肝硬化门静脉高压血流动力学参数的影响.中国病原生物学杂志, 2012, 7(3):220-221, 227.
19.	Yong Y, Ma JL, Yu JH. Multivariate analysis of portal vein thrombosis formation after devascularization in patients with portal hypertension. J Hepatobil Surg, 2014, 43(5):356-359.
20.	刘思达, 黎一鸣, 吉鸿, 等.贲门周围血管离断术治疗门静脉高压症疗效的Meta分析.中国普外基础与临床杂志, 2014, 21(1):69-75.
21.	吴晓峰, 伏志, 刘召波, 等.肝硬化门静脉高压患者行脾切除断流术后早期门静脉血栓形成的原因分析.临床肝胆病杂志, 2015, 31(3):400-403.
22.	包汉康, 韦秀丽.手助腹腔镜脾切除贲门周围血管离断术对肝硬化门静脉高压的疗效分析.临床肝胆病杂志, 2015, 31(3):431-433.
23.	Sun YW, Luo M, Chen W, et al. Portal vein thrombosis formation in patients submitted to portal hypertension operation. J Surg Concepts Pract, 2006, 92(6):108.
24.	罗凤球, 邓维成, 丁国建, 等.腹腔镜与开腹脾切除贲门周围血管离断术治疗门静脉高压症的Meta分析.中国普通外科杂志, 2013, 22(9):1195-1201.
25.	谢亮, 王姝, 蒋勇, 等.断流术联合肠腔分流术治疗肝硬变断流术后再出血23例报道.中国普外基础与临床杂志, 2015, 22(11):1366-1367.
26.	Kinjo N, Kawanaka H, Akahoshi T, et al. Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension. Br J Surg, 2010, 97(6):910-916.

1. Mercado MA, Orozco H, Ramírez-Cisneros FJ, et al. Diminished morbidity and mortality in portal hypertension surgery:relocation in the therapeutic armamentarium. J Gastrointest Surg, 2001, 5(5):499-502.
2. 张军, 邓克学.能谱CT预测肝硬化门静脉高压患者并发食管静脉曲张破裂出血风险.中国医学影像技术, 2012, 28(12):2201-2205.
3. Zong GQ, Fei Y, Chen J, et al. Selective double disconnection for cirrhotic portal hypertension. J Surg Res, 2014, 192(2):383-389.
4. Bureau C, Thabut D, Oberti F, et al. Transjugular intrahepatic porto-systemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology, 2016, [Epub ahead of print].
5. Zocco MA, Di Stasio E, De Cristofaro R, et al. Thrombotic risk factors in patients with liver cirrhosis:correlation with MELD scoring system and portal vein thrombosis development. J Hepatol, 2009, 51(4):682-689.
6. 李仓, 张启瑜, 孙克龙, 等.肝癌切除联合选择性减断流术在原发性肝癌合并中重度门静脉高压症中的应用.肝胆胰外科杂志, 2015, 27(1):5-8.
7. 叶剑桥.手术治疗肝硬化门静脉高压症并发上消化道出血临床疗效分析.检验医学与临床, 2014, 11(4):514-515.
8. 余灵祥, 张绍庚, 郭晓东, 等.门静脉高压症脾切断流术后血栓形成的临床研究.现代生物医学进展, 2014, 14(20):3857-3859.
9. Sun L, Zhou H, Gu L, et al. Effects of surgical procedures on the occurrence and development of postoperative portal vein thrombosis in patients with cirrhosis complicated by portal hypertension. Int J Surg, 2015, 16(Pt A):31-35.
10. 王茂春, 李澍, 朱继业, 等.门静脉高压症外科手术后门静脉系统血栓形成的原因及防治.中国乡村医药, 2004, 11(9):269-271.
11. 王东, 栗光明, 朱继业, 等.保脾断流术治疗门静脉高压症上消化道出血的疗效分析.中国普外基础与临床杂志, 2013, 20(1):29-32.
12. Marcus R, Peter H. Management of portal hypertension, Budd-Chiari syndrome and portal vein thrombosis. Medicine, 2015, 43(11):669-673.
13. 陈炜, 吴志勇.肝硬变门静脉高压症外科干预的时机和术式选择.中国普外基础与临床杂志, 2015, 22(11):1296-1299.
14. Makdissi FF, Herman P, Machado MA, et al. Portal vein thrombosis after esophagogastric devascularization and splenectomy in schisto-somal portal hypertension patients:what's the real importance? Arq Gastroenterol, 2009, 46(1):50-56.
15. 杨健, 钟麟.低分子肝素钙在脾切断流术后预防门静脉血栓形成的临床观察.中国药房, 2012, 23(24):2254-2257.
16. 杨科, 杨启.肝癌切除联合断流术治疗原发性肝癌合并门静脉高压症的疗效.世界华人消化杂志, 2014, 22(19):2780-2783.
17. 李铁汉, 唐波, 唐继红, 等.脾切除术后门静脉系血栓形成的临床诊治.中国普通外科杂志, 2010, 19(12):1324-1326.
18. 肖华鑫, 王敏, 李健, 等.普萘洛尔联合5-单硝酸异山梨酯对肝硬化门静脉高压血流动力学参数的影响.中国病原生物学杂志, 2012, 7(3):220-221, 227.
19. Yong Y, Ma JL, Yu JH. Multivariate analysis of portal vein thrombosis formation after devascularization in patients with portal hypertension. J Hepatobil Surg, 2014, 43(5):356-359.
20. 刘思达, 黎一鸣, 吉鸿, 等.贲门周围血管离断术治疗门静脉高压症疗效的Meta分析.中国普外基础与临床杂志, 2014, 21(1):69-75.
21. 吴晓峰, 伏志, 刘召波, 等.肝硬化门静脉高压患者行脾切除断流术后早期门静脉血栓形成的原因分析.临床肝胆病杂志, 2015, 31(3):400-403.
22. 包汉康, 韦秀丽.手助腹腔镜脾切除贲门周围血管离断术对肝硬化门静脉高压的疗效分析.临床肝胆病杂志, 2015, 31(3):431-433.
23. Sun YW, Luo M, Chen W, et al. Portal vein thrombosis formation in patients submitted to portal hypertension operation. J Surg Concepts Pract, 2006, 92(6):108.
24. 罗凤球, 邓维成, 丁国建, 等.腹腔镜与开腹脾切除贲门周围血管离断术治疗门静脉高压症的Meta分析.中国普通外科杂志, 2013, 22(9):1195-1201.
25. 谢亮, 王姝, 蒋勇, 等.断流术联合肠腔分流术治疗肝硬变断流术后再出血23例报道.中国普外基础与临床杂志, 2015, 22(11):1366-1367.
26. Kinjo N, Kawanaka H, Akahoshi T, et al. Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension. Br J Surg, 2010, 97(6):910-916.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk Factor Analysis of Portal Vein Thrombosis after Devascularization in Treatment of Patients with Cirrhotic Portal Hypertension

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