Clinical Study Of Yanggan Huayu Decoction In Preventing Portal Vein Thrombosis After Splenectomy And Devascularization

Objective To discuss the clinical efficacy of Yanggan Huayu Decoction in preventing portal vein thrombosis after Splenectomy and Devascularization,and provide experimental evidence of traditional Chinese medicine for prevention and treatment of portal vein thrombosis.Methods Choose 84 patients with portal hypertension and after Splenectomy and Devascularization from the general surgery of traditional chinese medicine hospital of shanxi province and 302 th hospital of PLA(Some patients are from 302 th hospital of PLA),beginning in January 2017 and ending in December 2018.The 84 patients were randomly divided into two groups,42 in the study group and 42 in the control group.Control group:postoperative routine anticoagulant therapy,low-molecular-weight heparin calcium injection 4000 IU,subcutaneous injection.Study group: on the basis of postoperative routine anticoagulant therapy(the same administration and method with control group),patients were given oral Chinese medicine Yanggan Huayu Decoction.Medication method:take the first dose 12 hours after the surgery,take the medicine 100 ml soup and take it through the stomach tube,Qd;After the gastric tube is pulled out about 3 to 5 days after the surgery,the above medicine is fried 400 ml,one dose per day,and the patients take the medicine heated with empty stomach in the morning and evening,which should last for 4weeks.Platelet count was measured before surgery,1,3,7,14,21 days after surgery,plasma D-dimer was measured before surgery,3,7,14,21 days after surgery.The portal vein venous thrombosis was measured by Doppler ultrasound system before and after 3,7and 14 days.ResultsThere were 4 patients quitting halfway,only 38 patients finished through the whole study in Treatment Group;with 2 patients dropping out halfway,40 patients left and finished the whole study in Control Group.1.Comparison of platelet counts between the two groups: There was no significant difference in platelet count between the study group and the control group before and after1,7,14,21 days(P>0.05);There was a significant differencein platelet count between the study group and the control group after 3 days(P<0.05).2.Comparison of Plasma D-dimer between the two groups: There was a significant difference in plasma D-dimer between the study group and the control group at 7 and 14 days after surgery(P<0.05).There was no statistically significant difference between the two groups preoperative,first day after surgery,3 days after surgery and 21 days after surgery(P>0.05).3.Comparison of portal vein thrombosis in the two groups:(1)No portal vein thrombosis was found in the study group and the control group before surgery;(2)The study group found 3 case of PVT 3 days after surgery,comparison with the control group found 5 cases were no significantly different(P>0.05);(3)The study group found 5 cases of PVT 7 days after surgery,comparison with the control group found 14 cases were significantly different(P<0.05);(4)The study group found 2 cases of PVT 14 days after surgery,comparison with the control group found 4 cases were no significantly different(P>0.05);(5)The PVT morbidity of the study group was 26.32%,compared with the control group(57.50%),was significantly different(P<0.05).ConclusionTraditional chinese medicine has a good effect in preventing portal vein thrombosis after after Splenectomy and Devascularization,and significantly reduces the incidence of postoperative portal vein thrombosis,which is superior to the prevention of western medicine alone.