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目的探讨晚期血吸虫病门脉高压症脾切除贲门周围血管离断术后门静脉血栓(PVT)形成的危险因素。方法收集2004年8月至2014年3月期间本院外科收治的211例晚期血吸虫病门静脉高压症患者的临床资料,对可能影响术后PVT形成的因素进行单因素分析和Logistic回归分析。结果 211例患者中,59例术后PVT形成,发生率为27.96%(59/211)。单因素分析显示术前上消化道出血史、门静脉直径、脾静脉直径、食管静脉曲张程度、腹水、门脉高压性胃病、胃底静脉曲张、血氨水平是患者术后PVT形成的影响因素。Logistic回归分析显示门静脉直径增宽(OR=1.763,P=0.000)和门脉高压性胃病(OR=1.089,P=0.037)是患者术后PVT形成的独立危险因素。结论晚期血吸虫病门脉高压症术后PVT形成的发生率较高,门静脉直径增宽和门脉高压性胃病是PVT形成的独立危险因素。
Objective To investigate the risk factors of portal vein thrombosis (PVT) in patients with advanced schistosomiasis and portal hypertension after splenectomy. Methods Clinical data of 211 patients with portal hypertension of advanced schistosomiasis collected in our hospital from August 2004 to March 2014 were collected. Univariate analysis and Logistic regression analysis were performed on the factors that may influence the postoperative PVT. Results Among the 211 patients, 59 cases had postoperative PVT, the incidence was 27.96% (59/211). Univariate analysis showed that the history of upper gastrointestinal bleeding, portal vein diameter, splenic vein diameter, esophageal varices, ascites, portal hypertensive gastropathy, gastric varices, blood ammonia levels were the influencing factors of postoperative PVT. Logistic regression analysis showed that portal vein diameter widening (OR = 1.763, P = 0.000) and portal hypertensive gastropathy (OR = 1.089, P = 0.037) were independent risk factors for postoperative PVT. Conclusions The incidence of postoperative PVT in patients with advanced schistosomiasis is high. The widening of portal vein diameter and portal hypertensive gastropathy are independent risk factors of PVT.