Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension
Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension
复制标题
DOI：
10.1002/bjs.7002
复制
发表时间：
2010-06-01
影响因子：
9.6
通讯作者：
Maehara, Y.
中科院分区：
文献类型：
--
作者：
Kinjo, N.;Kawanaka, H.;Maehara, Y.
背景：门静脉血栓形成（PVT）是脾切除术后潜在的致命并发症。其机制和危险因素知之甚少，特别是在肝硬化和门静脉高压症患者中。本研究调查了PVT的危险因素，脾切除术后，这样的patients.Methods：所有连续的肝硬化患者在九州大学医院脾切除术1998年和2004年之间被纳入本回顾性研究。根据术后有无门静脉血栓形成分为两组，比较术前及术中影响门静脉血栓形成的因素，分析门静脉血栓形成与其自变量的关系。在某些情况下，门静脉血流量测量脾切除术前后使用双功多普勒ultrasonography.Results：门静脉血栓形成手术后17（24%）的70例患者研究。多因素分析显示，脾静脉直径增大和白色细胞计数减少是门静脉血栓形成的独立危险因素。门静脉血栓形成组脾切除术后门静脉血流量明显减少，而无门静脉血栓形成组门静脉血流量无明显减少。结论：脾静脉直径增大和白色细胞计数减少是肝硬化门静脉高压症脾切除术后门静脉血栓形成的独立危险因素。
Background: Portal venous thrombosis (PVT) is a potentially fatal complication following splenectomy. Its mechanisms and risk factors are poorly understood, especially in patients with cirrhosis and portal hypertension. This study investigated risk factors for PVT following splenectomy in such patients.Methods: All consecutive patients with cirrhosis who underwent splenectomy in Kyushu University Hospital between 1998 and 2004 were included in this retrospective study. They were divided into two groups based on the presence or absence of postoperative PVT. Preoperative and operative factors were compared, and the relationships between formation of PVT and its independent variables were analysed. In some cases, portal venous flow was measured before and after splenectomy using duplex Doppler ultrasonography.Results: PVT developed after surgery in 17 (24 per cent) of 70 patients studied. Multivariable analysis showed that increased splenic vein diameter and low white cell count were significant independent risk factors for PVT. Portal venous flow after splenectomy was greatly reduced in the PVT group, but not in patients without PVT.Conclusion: Large splenic vein diameter and low white cell count are independent risk factors for PVT after splenectomy in patients with cirrhosis and portal hypertension.