Chin J Schisto Control ›› 2015, Vol. 27 ›› Issue (6): 650-.DOI: 10.16250/j.32.1374.2015160

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Application of perfusion of low molecular dextran via splenic artery in portal azygous devascularization for portal hypertension

LIU Li-jun*| YU Wei| KUANG Yong-jun   

  1. Department of Surgery| Hanchuan People’s Hospital| Hanchuan 431600| China
  • Online:2015-12-22 Published:2015-12-22

经脾动脉灌注低分子右旋糖酐在门脉高压症断流术中的应用

刘礼军*|余伟|匡勇军   

  1. 湖北省汉川市人民医院、 武汉大学人民医院汉川医院肝胆外科 (汉川 431600)
  • 作者简介:刘礼军| 男| 本科| 副主任医师。研究方向: 肝胆及微创外科

Abstract: Objective To evaluate the effects of the perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension in the prevention from portal vein thrombosis. Methods A total of 92 patients with portal hypertension were randomly divided into a control group (46 cases) that received the extensive devascularization around the cardia, and a trial group (46 cases) that received the above?mentioned operation and the perfusion of low molecular dextran via the splenic artery. The incidence of portal vein thrombus after the operation and the preoperative and postoperative blood transfusion were observed and the results were analyzed and compared between the two groups. Results The incidence of thrombosis and blood transfusion were 26.1% (12/46) and CRBC 4 ~ 6 U respectively in the control group, while those were 4.3% (2/46) and CRBC 2 ~ 3 U respectively in the trial group. The differences were statistically significant (P<0.05). Conclusion The perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension is effective and safe in the prevention from portal vein thrombosis.

Key words: Cirrhosis; Portal hypertension; Low molecular dextran; Perfusion of splenic artery; Devascularization

摘要: 目的 探讨门脉高压症断流术中应用低分子右旋糖酐经脾动脉灌注,对预防门静脉系统血栓形成的效果。方法 选取本院2009年1月-2013年10月门脉高压症断流术患者92例,随机分为2组,对照组46例行脾切除及贲门周围血管离断术,实验组46例行门脉高压断流术,且术中应用低分子右旋糖酐脾动脉灌注,对2组病例术后门静脉血栓发生率、术中术后输血量进行统计分析。结果 实验组患者术后门静脉血栓发生率为4.3%(2/46),浓缩红细胞输血量2 ~ 3 U,对照组患者血栓发生率及浓缩红细胞输血量分别为26.1%(12/46)和4 ~ 6 U,差异有统计学意义(P均< 0.05)。结论 术中经脾动脉低分子右旋糖酐灌注在门脉高压症脾切除术中操作安全可行,能有效降低术后门静脉系统血栓的发生率,且节约血源,减少用血量,值得临床推广应用。

关键词: 肝硬化;门脉高压症;低分子右旋糖酐;脾动脉灌注;断流术

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