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.

Objective To evaluate curative effect and safety of anticoagulant drugs used in perioperative period to prevent deep vein thrombosis (DVT) after rectal carcinoma surgery. Methods Clinical data of 96 postoperative rectal carcinoma cases from January 2006 to June 2009 were analyzed retrospectively.These cases were divided into two groups:48 cases in nonanticoagulant group and 48 cases in anticoagulant group.After radical operation of rectal carcinoma,low molecular heparin calcium was injected subcutaneously daily for 8 consecutive days beginning the day before surgery in anticoagulant group. Results Incidence of DVP in anticoagulant group (4%) was significantly lower than that in noncoagulant group (19%) (x2 = 5.031,P ＜ 0.05).Postoperative hospitalization time in anticoagulant group [(12 ± 3) d] was significantly shorter than that of nonanticoagulant group [(22 ± 6) d] (t = 10.328,P＜ 0.01).There were no significant differences between two groups in operative time,blood loss and postoperative blood drainage,peripheral blood platelet counts before and after operation,prothombin time and active part thrombin time before and after operation,the time when postoperative DVT developes;secondary adverse reactions; postoperative major complication rate and mortality (all P ＞ 0.05). Conclusion Anticoagulant drugs used in perioperative period is safe and effective in prevention of deep vein thrombosis in lower limbs after radical operation of rectal carcinoma.