The Clinical Application Research Of The Preventive Threatment Theory Based On Splenectomy Portal Vein Thrombosis

ObjectiveTo discuss the clinical application efficacy on the ideal of TCM treating predecease in the portal venous system thrombosis formation after the splenetic, to provide a scientific basis for form further popularization and application of the clinical treatment.Methods chose 80 patients required splenectomy surgery from The General Surgery Ⅰof The First Affiliated Hospital Anhui University of Chinese Medicine,from December,2011 to December,2014.All patients were randomly divided into control group and the reach group,44 cases of control group and the research group is 36 cases.(1) the research group: After Spleen Resection Surgery,prevent infection and protection function of viscera function, nutritional support, stop bleeding and rehydration treatment.When the Color Doppler Ultrasound examination found no postoperative portal vein system thrombosis,The blood routine examination revealed PLT > 300×109/L,Application intervention programs of traditional Chinese medicine intervention.The blood routine examination revealed PLT > 500×109/L,Application of traditional Chinese medicine +aspirin(20 mg) +dipyridamole(30 mg),oral, twice a day.The blood routine examination revealed PLT >1000×109/L,Add with low molecular weight heparin 4000 UI subcutaneous injections of intervention.For the Color Doppler Ultrasound examination found postoperative portal vein system thrombosis,Intravenous drip intervention combined with urokinase 200000 units, twice a day.(2) The control group:After Spleen Resection Surgery,Implement the routine postoperative treatment.When the Color Doppler Ultrasound examination found no postoperative portal vein system thrombosis,no clinical intervention.For the Color Doppler Ultrasound examination found postoperative portal vein system thrombosis,Application intervention programs of traditional Chinese medicine + aspirin and dipyridamole+low molecular weight heparin+urokinase,Use the same as the group ofdrugs, methods, treatment group.Observe two groups of patients with preoperative and postoperative platelet amount,Plasma D- dimer level,Liver function indicators(including ALT、AST、TBi L、TBA、ALB),Portal venous system thrombosis.Results(1)Body temperature comparison:comparison with the body temperature of the study group and the control group for the preoperative and the first day, the third day and the21 st day after postoperative were not significant difference(P>0.05).comparison with the study group and the control group for the 7th day and the 14 st day after postoperative were significantly different(P<0.05).(2)PLT count comparison:comparison with the PLT count of the study group and the control group for the first day, the 7th day, the 14 th day and the 21 st day after postoperative were not significant difference(P>0.05).comparison with the study group and the control group for the third day after postoperative were significantly different(P<0.05).(3)Plasma D-dimer level comparison:comparison with the Plasma D-dimer level of the study group and the control group for the preoperative and the 21 st day after postoperative were not significant difference(P>0.05).comparison with the study group and the control group for the 7th day and the 14 th day after postoperative were significantly different(P<0.05).(4)Serum ALT comparison:comparison with Serum ALB of the study group and the control group for the preoperative and the first day, the third day, the 7th day, the 14 th day and the 21 st day after postoperative were not significant difference(P>0.05).(5)Serum AST comparison:comparison with the Serum AST comparison of the study group and the control group for the preoperative and the first day, the 7th day, the 14 th day and the 21 st day after postoperative were not significant difference(P>0.05).comparison with the study group and the control group for the third day after postoperative were significantly different(P<0.05).(6)Serum TBi L comparison:comparison with Serum TBi L of the study group and thecontrol group for the preoperative and the first day,the 14 th day and the 21 st day after postoperative were not significant difference(P>0.05).comparison with the study group and the control group for the third day and the 7th day after postoperative were significantly different(P<0.05).(7)Serum ALB comparison:comparison with Serum ALB of the study group and the control group for the preoperative and the first day, the third day, the 7th day, the 14 th day and the 21 st day after postoperative were not significant difference(P>0.05).(8)The study group found 18 cases PVT after postoperative the 7th day,comparison with the control group found 6 cases were significantly different(P<0.05);The study group found 6 cases PVT after postoperative the 14 th day,comparison with the control group found 3 cases were significantly different(P<0.05);The study group found 1 cases PVT after postoperative the 21 st day,comparison with the control group found 1 cases were no significantly different(P>0.05);The PVT morbidity of the control group was 56.81%,compared with the study group(27.78%),was statistically significant(P<0.05).Conclusion The application of the preventive treatment theory of TCM in after the Splenectomy contributes to prevention and treatment of portal venous system thrombosis,Early use of Chinese medicine treatment was safe and effective,can reduce the incidence of PVT and reduce the postoperative complications.