胃底静脉曲张组织黏合剂注射术后门静脉血栓形成的危险因素分析

发布时间：2018-08-22 14:44

【摘要】：【目的】分析内镜下肝硬化并胃底静脉曲张组织黏合剂注射治疗(GVI)术后门静脉血栓发生率及与肝硬化疾病相关的影响门脉血栓形成的危险因素。【方法】回顾性分析我院2009年8月至2014年6月因肝硬化伴胃底重度静脉曲张住院并行首次胃底组织黏合剂治疗的患者157例。记录其临床资料,GVI术后1年内出现门脉血栓者为血栓组,未出现血栓者为非血栓组。应用Logistic回归模型,筛选肝硬化合并胃底静脉曲张患者行GVI后发生门静脉血栓的危险因素。【结果】纳入本研究的157例患者中,首次GVI术后1年内出现门静脉血栓者39例,未出现门静脉血栓者118例,门静脉血栓发生率为24.84%。Logistic回归分析表明,术前脾长径、术中碘油注射量在血栓组及非血栓组中差异有统计学意义(P值分别为0.022、0.027;OR值分别为1.021、1.739,95%CI分别为1.003~1.040、1.066~2.837)。【结论】术前脾长径、术中碘油注射量可能是影响GVI术后门脉血栓形成的独立危险因素,肝硬化合并胃底静脉曲张患者行GVI术前需了解脾肿大情况,术中合理控制碘油注射量,以减少术后门静脉血栓发生的可能。
[Abstract]:[objective] to analyze the incidence of portal vein thrombosis after (GVI) and the risk factors associated with portal vein thrombosis after endoscopic liver cirrhosis with gastric variceal varicose tissue adhesive injection. [methods] From August 2009 to June 2014, 157 cases of liver cirrhosis with severe varicose gastric fundus were treated with the first gastric fundus tissue adhesive therapy in our hospital. The clinical data of the patients with portal thrombosis within 1 year after GVI were recorded as thrombus group, and those without thrombus were non-thrombus group. Logistic regression model was used to screen the risk factors of portal vein thrombosis after GVI in patients with liver cirrhosis and gastric varices. [results] among the 157 patients included in this study, 39 patients had portal vein thrombosis within one year after the first GVI operation. The incidence of portal vein thrombosis was analyzed by 24.84%.Logistic regression analysis. There was significant difference in intraoperative injection of lipiodol between thrombus group and non-thrombus group (P = 0.022 ~ 0.027 OR = 1.021 ~ 1.739 ~ 95 CI = 1.003 ~ 1.0401.066 ~ 2.837, respectively). [conclusion] the length of spleen before operation. Intraoperative injection of lipiodol may be an independent risk factor for portal thrombosis after GVI. Patients with liver cirrhosis complicated with gastric varices should know the splenomegaly before GVI and control the amount of lipiodol injection during operation. In order to reduce the possibility of postoperative portal vein thrombosis.
【作者单位】：中山大学附属第三医院消化内科;
【基金】：国家自然科学基金(81370511) 教育部博士点基金(2012171110081) 中山大学高校基本科研业务项目(14YKPY27)
【分类号】：R575.2

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