Aspirin and low molecular weight heparin in the prevention of portal venous thrombosis after pericardial disconnection
10.3760/cma.j.issn.1007-631X.2010.04.011
- VernacularTitle:早期应用阿司匹林联合低分子肝素钙预防断流术后门静脉系统血栓形成
- Author:
Yan LI
;
Jingkui YU
- Publication Type:Journal Article
- Keywords:
Venous thrombosis;
Aspirin;
Heparin,low molecular weight;
Hypertension,portal
- From:
Chinese Journal of General Surgery
2010;25(4):299-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of early aspirin combined with low molecular weight heparin calcium in prevention of portal system thrombosis after portaazygous disconnection in patients of portal hypertension.Methods In this study.90 cases with cirrhotic portal hypertension were divided randomly into two groups(control group:44 cases,observation group:46 cases),after standard splenectomy and pericardial devascularization.On the day when abdominal and gastrointestinal drain was not bloody(at 2-5d,mean 3d after operation),low molecular weight heparin calcium 4100 IU per day was given to observation group by subcutaneous injection for 10 days.During treatment,blood platelet(PLT)count was monitored.When PLT in both groups>300 ×10~9/L.low molecular dextran 500 ml per day was given by iv drip for 7-14 days,oral enteric aspirin 100 ms/day was given,until PLT reached normal range.Portal venous thrombosis was evaluated by color Doppler ultrasonography weekly for 3 weeks.Results Postoperative incidence of portal vein thrombosis in observation group(7%)was lower significantly than that in control group(27%)(X~2=6.972,P<0.05).Incidence of postoperative complications in observation group(7%)were lower significantly than that in control group(32%)(X~2=9.393,P<0.01).Mortality rate in observation group(2%)were lower significantly than that of control group(18%)(X~2=4.748.P<0.05).There was no significant difference between the two groups in blood platelet count during observation(P>0.05).Prothrombin time,active pact thromboplastin time were also similar in the two groups(P>0.05).Side effect such as self-limited subcutaneous hemorrhage developed in no cases in control group compared to two cases in observation group(X~2=0.558,P>0.05).Conclusion It is a safe and effective method to use early aspirin combined with low molecular weight heparin in the prevention of portal system thrombosis after splenectomy and portaazygous devascularization in cirrhotic portal hypertensive patients.
