Clinical Analysis Of Liver Cirrhosis With Portal Vein Thrombosis And Analysis Of Coagulation Related Indexes

Purpose and background:Liver cirrhosis is a common clinical chronic liver disease,portal vein thrombosis is a rare complication of decompensated liver cirrhosis.With the development of medical imaging technology,more and more portal vein thrombosis is found.Portal vein thrombosis is an important event of liver cirrhosis,because it can increase the risk of gastrointestinal bleeding in patients with cirrhosis and exacerbate liver function deterioration.In this perper,through reviewed clinical data and clotting date to analyze the clinical features of liver cirrhosis with portal vein thrombosis,which will help clinicians to improve the understanding of cirrhosis with portal vein thrombosis,so as to achieve early identification of high-risk factors,early diagnosis and treatment.Methods:Collected 36 cases of liver cirrhosis complicated with portal vein thrombosis from March 2015 to March 2018 in the Second Affiliated Hospital of Nanchang University.28 cases were included in the criteria.The history,main complaint,cause,PLT,PT,APTT,Fg,D-dimer,liver function,abdominal imaging examination and treatment methods were collected.Collected 918 patients with cirrhosis at the same time.56 patients with liver cirrhosis were randomly selected as the control group.In order to analyze the morbidity,etiology,high-risk factors,diagnostic methods and treatment methods of cirrhosis with portal vein thrombosis and analyze the correlation of coagulation-related parameters between two groups.Result:Liver cirrhosis with portal vein thrombosis was mainly caused by hepatitis B cirrhosis in 16 cases(57.14%)and schistosomiasis in 4 cases(14.29%).The major risk factors were History of splenectomy in 5 cases,splenectomy and sclerotherapy and(or)ligation history in 4 cases.There was no statistically significant difference in the prothrombin time,activated partial thromboplastin time,and fibrinogen concentration between the two groups in the comparison of coagulation-related indexes.D-dimer levels in the thrombus group were elevated(P<0.001)and platelet elevations(P<0.05)were observed.The main method for the diagnosis of portal vein thrombosis was multi-phase enhanced CT or MRI.The treatment was mainly symptomatic treatment,anticoagulation,TIPS treatment.Conclusion:B virus-related cirrhosis is a major cause of cirrhosis with PVT.Schistosome cirrhosis also occupies an important proportion.Liver function Child-Pugh B and Child-Pugh C are the major causes of liver cirrhosis with PVT.Cirrhosis with PVT mostly affects the main branch of portal vein.Splenectomy and partial splenic embolism accounted for a large proportion of liver cirrhosis with portal vein thrombosis.There was no statistical difference in PT,APTT,Fg between the thrombosis group and the control group.It was not yet clear that the patients with portal vein thrombosis had systemic hypercoagulability.The relative elevation of platelets is a risk factor for cirrhosis with portal vein thrombosis.D-dimer is important for the diagnosis of portal vein thrombosis.The diagnosis of cirrhosis with PVT mainly depends on color Doppler ultrasound,multi-phase enhanced CT,and MRI.Treatment is mainly anticoagulation and TIPS,TIPS is safe and effective.