关键词: 门静脉高压症, 脾切除术, 断流术, 门静脉血栓形成

Abstract:

Objective To investigate the safety and efficiency of portal vein catheterization for prevention and treatment of portal vein thrombosis after splenectomy and devasculation. Methods From April 2004 to May 2005, 35 cases of post-operative patient undergoing performed splenectomy and devasculation, catheters were placed and retained in portal veins through right gastroepiploic veins. Anticoagulation and thrombolysis treatment were given after operations. The changes of platelet, hemodynamics of portal vein, incidence of infection and thrombosis, outcome of thrombolysis were analysed. Results Platelet level rised after operation, reached peak about two weeks later, and lowered to normal about 1 month later. The maximum and mean velocity of portal vein blood flow became slower. There was 1 case who suffered from sepsis through portal vein catheter. 5 cases(14.28%) suffered of portal vein thrombosis before operations. 7 cases developed portal vein thrombosis after operations. 6 cases(85.72%) of portal vein thromboses were given thrombolysis through portal vein catheters. Conclusion Portal vein thrombosis can be prevented and treated efficiently with anticoagulation and thrombolysis through portal vein catheter, which give these patients opportunities for liver transplantation later.

Key words: portal hypertertension, splenectomy, devasculation, portal vein thrombosis