The Early Application Of Low Molecular Weight Heparin In Preventing Postoperative Portal Vein System Thrombosis After Laparoscopic Splenectomy With Esophagogastric Devascularization

Objective:To investigate the curative effect and security of low molecular weight heparin in preventing postoperative portal vein system thrombosis after laparoscopic splenectomy with esophagogastric devascularization.Methods:The clinical data of patients with portal hypertension receiving laparoscopic splenectomy with esophagogastric devascularization in the first affiliated hospital of Zhejiang university from January2012to January2015were analyzed retrospectively. Of which41cases of patients with complete clinical data were conformed to the standards. According to whether with postoperative early application of low molecular heparin, patients were divided into experimental group and control group. The postoperative liver function and coagulation indexes of patients were periodic reexamination and color doppler ultrasound was performed at the1st day after the operation and the day before hospital discharge and two months after the operation respectively to know thrombosis of portal vein. Any partial or complete mural thrombus in the splenic vein and superior mesenteric vein, inferior mesenteric vein and portal vein trunk can be diagnosed as PVST. Statistical analysis was done by SPSS20.0software. Continuous variables were expressed as (x±s), which was analyzed by student’s t-test between two groups; Categorical variables was analyzed by chi-square test, and there was significantly difference when P<0.05.Results:There are no obvious difference (P>0.05) between control group and LMWH groups in gender, age, general situation, preoperative and postoperative liver function and blood coagulation indexs. At the time of hospitalization, the incidence of postoperative PVST was56.25%in the control group and12%in the LMWH group, of which the difference between two groups was statistically significant (P<0.05). Two months after the operation, the incidence of postoperative PVST was68.75%in the control group and16%in the LMWH group, of which the difference between two groups was statistically significant (P<0.05).Conclusion:The early preventive systemic application of LMWH is effective in preventing PVST after LSED, and does not increase the morbidity risk.