中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (05): 406-408.

• 论著 • 上一篇    下一篇

门静脉高压症断流术后门静脉血栓形成诊治分析

乌剑利，杨 镇，王 超，魏卫卫，肖 亮，李岽健，刘敦贵   

  1. 华中科技大学同济医学院附属同济医院普外科，湖北武汉430030
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-05-13 发布日期:2009-05-13

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-05-13 Published:2009-05-13

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摘要：

目的 探讨门静脉高压症断流术后门静脉系统血栓形成（PVT）的诊治方法。 方法 回顾性分析华中科技大学同济医学院附属同济医院1993年4月至2008年10月行断流术后并发PVT的72例病人临床资料。结果 断流术后PVT于术后9～21d好发于脾静脉、门静脉主干等部位，经溶栓、抗凝或手术治疗，除1例因肠坏死合并中毒性休克而死亡外，余经治疗PVT均消失，其中1例发生短肠综合征。结论 腹部彩超或CT是PVT的确诊方法，术中操作轻柔、术后监测血小板计数、腹部彩超或CT、早期溶栓抗凝、及时手术是防治PVT的有效方法。

关键词: 门静脉高压症, 断流术, 血栓形成

Abstract:

Diagnosis and treatment of portal vein thrombosis in patients with portal hypertension disconnection after operation WU Jian-li, YANG Zhen, WANG Chao, et al. Department of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China Corresponding author：YANG Zhen, E-mail： zyang@tjh.tjmu.edu.cn Abstract Objective To investigate diagnosis and treatment of portal vein thrombosis （PVT）in patients with portal hypertension disconnection after operation. Methods The clinical data of 71 cases of PVT after disconnection admitted between April 1993 and October 2008 at Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology were analyzed retrospectively. Results The predilection area of postoperative PVT was splenic vein and portal vein in 9—21d after operation.Among them, except for one case died of intestinal necrosis combined toxic shock, all cases were recovered. But one case occurred in short bowel syndrome. Conclusion Abdominal doppler ultrasound or CT is the road of definite diagnosis. Operation standardization, dynamic examining platelet count, routine doppler ultrasonography or CT examining, early thrombolysis and anticoagulation therapy are the effective methods in preventing and managing PVT postoperation for potal hypertension disconnection.

Key words: portal hypertension, disconnection, thrombosis