The Risky Factors Of Portal Vein Thrombosis In Patients Submitted To Portal Hypertension Operation

Background1868,Balfour and Stewart report the first case of the Portal Vein Thrombosis(PVT),with the appearance of hypersplenotrophy, hydroperitoneum and esophageal varix.The patients with chronic PVT maybe only show some atypia symptom such as anorexia and acratia.So,without effective imageology check,such as Ultraphonic Doppler, the patients may be missed diagnosis. For this reason,it is very hard to get rigorous epidemiology data of the PVT.One epidemiological investigation of the United States of America show the disease incidence of PVT is (0.05-0.5)%,while the disease incidence of PVT in Japan is close to it. In western countries,PVT account (5-10)% of the portal hypertension. In then developing country, PVT account 40% of the portal hypertension. The disease incidence of PVT with hepatic cirrhosis is(0.6-64.1)%,the difference is made decision by the diagnostic method and the inclusion criteria of the patient.PVT is not rare in the patient with the liver transplantation, the incidence is abou(t2.1-26)%. In a word,PVT has a higher clinical significance.But in our country, the clinician pay less attention to PVT.ObjectiveTo investigate the Risky Factors,the incidence and causes of postoperative portal vein thrombosis (PVT) in patients.MethodsThe clinical data of 129 patients with portal hypertention receiving devascularization or devascularization with spleno-renal shunt operation (combination group) in our hospital from 2001 to 2008 were retrospectively analyzed.The data of patients about age, sex were collected to be analyzed, the level of platform was examined, and the diameter and the blood flow of portal vein were measured by Doppler ultrasonography.ResultsPVT occurred after operation in 20 of 129 patients (20/129, 15.50%). The incidence of PVT in devascularization group was 18.18%(16/88). The incidence of PVT in combination group was 9.76%(4/41). The diameter of the portal vein and the splenic vein of the patients with PVT increased more than that of those without PVT(P < 0.05), and the blood flowof the portal vein in patients with PVT was slower than that in those without PVT (P < 0.05). The FPP the patients with PVT was lower than that of those without PVT(P < 0.05). There were no significant differences of the sex,the age,the Child-pugh classification,prothrombin time and platlet counting in the two groups of patients with or without PVT (P > 0.05).ConclusionsThe risk factors of PVT are the increased diameter of the portal vein and the splenic vein,the alleviation of the blood flowof portal vein,and the lower FPP.Well-designed randomized studies on the PVT after splenectomy are urgently needed.