Effects Of Anatomical Splenectomy And Anticoagulant Therapy In Prevetion Of Portal Vein Thrombosis In Patients After Splenectomy For Portal Hypertension

Objective: To investigate the effects and mechanisms of anatomical splenectomy and early using anticoagulant therapy in prevention of portal system thrombosis in patients after splenectomy or pericardial devascularization and splenectomy for portal hypertension.Methods: The clinical data of 80 patients with portal hypertension due to hepatic cirrhosis receiving splenectomy or pericardial devascularization and splenectomy in our hospital from January 2007 to February 2010 were retrospectively analyzed.80 patients were randomly divided into two groups:treatment group (n=46),receiving anatomical splenectomy or pericardial devascularization and anatomical splenectomy,meanwhile,receiving early using anticoagulant therapy after operation,and control group (n=34), receiving traditional splenectomy or pericardial devascularization and traditional splenectomy without using anticoagulant therapy after operation.Each patient received antiplatelet therapy after operation when platelet count was over 300×109/L.Observation factors include blood routine,coagulation Profile,the incidence of pancreatic fistula and subphrenic infection,the hemorrhagic tendency and the incidence of portal system thrombogenesis after operation.Results: The incidence of postoperative portal system thrombosis was 2.2%(1/46) in treatment group, 26.5%(9/34) in control group, the incidence of portal system thrombosis was significantly different between two groups( x 2=10.552 , P < 0.05) , but the hemorrhagic tendency and coagulation Profile were not significantly different(P>0.05).Conclusion: Anatomical splenectomy and early using anticoagulant therapy can reduce the occurrence of portal vein thrombosis, early using anticoagulant therapy after operation is safe.