论文部分内容阅读
目的探讨原发性肝癌切除术后门静脉血栓形成的可能原因及防治方法。方法回顾分析我科自2013年1月~2014年10月8例原发性肝癌患者行肝部分切除术后门静脉血栓形成的临床资料,包括患者的一般资料、手术部位、术后临床化验指标、相关的影像学检查结果、临床处理及预后。结果原发性肝癌切除术后门静脉血栓形成的发生率为2.05%(8/389),均发生在术后10天内,临床表现以腹胀、腹部不适、腹水形成、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素和乳酸脱氢酶在短时间内急剧升高为初发表现。除3例门静脉血栓早期予抗凝、溶栓治疗后存活;其余5例门静脉主干血栓者经抗凝及溶栓治疗无效,均于血栓形成2周左右死亡。结论门静脉血栓形成是原发性肝癌切除术后一种少见的,但却是相当的严重的并发症,其确切的发病机制、有效的预防及治疗方法需重视和进一步研究。
Objective To explore the possible causes of portal vein thrombosis after primary hepatectomy and its prevention and treatment. Methods The clinical data of portal vein thrombosis after partial hepatectomy in 8 patients with primary liver cancer from January 2013 to October 2014 in our department were retrospectively analyzed. The data including the general data, operation site, postoperative clinical laboratory indexes, Related imaging findings, clinical management and prognosis. Results The incidence of portal vein thrombosis after primary hepatectomy was 2.05% (8/389), both of which occurred within 10 days after operation. The clinical manifestations included abdominal distension, abdominal discomfort, ascites formation, alanine aminotransferase, aspartate aminotransferase, Bilirubin, direct bilirubin and lactate dehydrogenase increased sharply in a short period of time as the initial performance. In addition to 3 cases of portal vein thrombosis early to anticoagulant, thrombolytic therapy survived; the remaining 5 cases of portal vein thrombosis by anticoagulation and thrombolytic therapy are invalid, were thrombosis in about 2 weeks of death. Conclusions Portal vein thrombosis is a rare but serious complication after primary hepatectomy. The exact pathogenesis, effective prevention and treatment methods need to be emphasized and further studied.