Effect Of Second Spleen Detachment Surgery On Portal Vein Thrombosis In Cirrhotic Portal Hypertension

Objective:To investigate the effect of secondary splenic detachment and portal denervation on portal vein thrombosis in patients with cirrhosis and portal hypertension,and to obtain the specific mechanism of portal vein thrombosis after secondary spondyl detachment.Methods:A retrospective analysis was performed on 160 patients undergoing traditional splenectomy + portal debridement or secondary spondyl detachment + portal devascularization for cirrhosis with portal hypertension from 2002 to 2016 in Shanxi Provincial People's Hospital.First,analyze and discuss the ratio of thrombosis of the two types of surgical procedures to determine whether the difference in thrombus ratio is significant;secondly,divide 160 patients into thrombosis group(64 persons)and non-thrombosis group(96 persons).Tests and independent sample t-tests were performed to analyze the Child grading of liver function,spleen and rib thickness,portal vein diameter,coagulation series,postoperative portal vein diameter and blood flow velocity,and postoperative platelet counts.Related factors.Finally,the thrombosis group(64 persons)was divided into secondary spleen detachment group(17 patients)and traditional splenectomy group(47 patients).The independent sample t-test was used to analyze the above-mentioned thrombotic factors and whether there was any Statistical significance.Results:(1).The incidence of thrombosis was 28.3%after secondary spleen detachment,and the rate of thrombosis was 47%after traditional splenectomy.The statistical results showed that?2 =4.684,P=0.030<0.05.There was a statistical difference.Secondary splenic pedicle detachment surgery can reduce the formation of portal vein thrombosis compared to traditional splenectomy.(2).Compared with the non-thrombosis group,there were statistically significant differences in the four indicators of spleen and rib thickness,inner diameter of portal vein,diameter of posterior portal vein,and portal vein velocity after surgery(P<0.05).Others,such as preoperative leukocytes,hemoglobin,bilirubin,etc.,showed no difference,indicating that the effect on thrombosis was not obvious.(3).Secondary spleen pedicle separation group and traditional splenectomy group,analysis of spleen and rib thickness,portal vein diameter,postoperative portal vein diameter,postoperative portal vein blood flow velocity,there was no significant statistical difference.Conclusion:The four indicators of spleen and rib thickness,internal diameter of portal vein,internal diameter of postoperative portal vein,and postoperative portal vein velocity are independent risk factors for postoperative portal vein thrombosis,while secondary spondylectomy can reduce postoperative portal vein thrombosis.Formed,but the specific mechanism is unclear,and it remains to be studied...