Relevant Factor Of Portal Vein Thrombosis In Patients After Splenectomy And Portal-azygous Devascularization For Portal Hypertensive Patient

OBJECTIVE:To analyze the relevant factors of portal vein thrombosis in patients with portalhypertension caused by hepatic cirrhosis after spleenectomy and portaazygousdevascularization.METHODS:The clinical data of77patients with hypertension due to cirrhosis resulting fromhepatitis receiving simple splenectomy or splenectomy and portal-azygousdevascularization in the first affiliated hospital of Nan Chang university fromSeptember2011to September2012were retrospectively analyzed. And the caseswere divided into the thrombosis group and non-thrombosis group. The generalinformation concluding that gender、age、Pugh、perioperative red blood cell and whiteblood cell count (preoperative to postoperative), preoperative coagulation、operationtime、 intraoperative bleeding、 intraoperative splenic artery ligation、 platelettransfusion、 platelet count before and1,7,14days after operation、D-dimer beforeand1,7days after operation、the color ultrasound indicators of the portal vain（preoperative to postoperative）、spleen quality、operation methods were comparedbetween the two groups and the factors mentioned above were determined instatistical methods.RESULTS:Portal vein thrombosis occurred in31patients and the others in77of patientswere not.，the incidence rate is38.9%. Regression univariate analysis showed that theportal vein thrombosis was related to the D-dimer (7days after operation)、the insidediameter of portal vain after operation, and the blood flow of portalvein postoperatively, but not to gender、age、Pugh、perioperative red blood cell andwhite blood cell count (preoperative to postoperative), preoperative coagulation、operation time、intraoperative bleeding、intraoperative splenic artery ligation、platelettransfusion、 platelet count before and1,7,14days after operation、D-dimer beforeand1days after operation、the inside diameter of portal vain before operation, the blood flow of portal vein preoperatively、spleen quality and operation methods.Theright predictive rate of PVT was84.4%.CONCLUSION:The risk factors of PVT are the increased D-dimer (7days after operation)、theinside diameter of portal vain before operation, and the increased blood flow of portalvein postoperatively is the protective factors.