肝细胞癌肝切除术后门静脉血栓形成10例诊治分析
发布时间：2018-08-02 16:46
【摘要】：目的探讨肝细胞癌肝切除术后门静脉血栓形成的可能原因及预防措施。方法回顾性分析2010年1月至2013年12月第二军医大学附属东方肝胆外科医院收治的10例肝细胞癌肝切除术后门静脉血栓形成的病人资料,包括一般资料、既往病史、术前检查、术中情况、术后检查诊断及治疗措施等。结果门静脉血栓确诊时间为术后3~15 d,平均为6.6 d。术后9例病人出现肝功能迅速恶化,表现为术后丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)逐渐下降后突然升高,确诊当日TBIL为159.4(9.5~472.9)μmol/L,ALT为1175.4(73.9~5485)U/L。6例病人术后行D-二聚体检查,其中5例(83.3%)明显升高(20 mg/L),1例轻度升高(≤20 mg/L)。10例均常规术后使用止血药物,且均于确诊门静脉血栓后开始使用低分子肝素抗凝治疗。3例抗凝治疗后门静脉血流恢复,好转出院;6例因急性肝功能衰竭死亡;1例因急性肾功能衰竭、感染性休克死亡。结论肝细胞癌肝切除术后门静脉血栓形成可以导致病人术后肝功能衰竭甚至死亡,故建议肝切除术后宜慎用止血药并早期抗凝。
[Abstract]:Objective to investigate the possible causes and preventive measures of venous thrombosis after hepatectomy for hepatocellular carcinoma (HCC). Methods from January 2010 to December 2013, the data of 10 patients with venous thrombosis after hepatectomy were retrospectively analyzed, including general information, past medical history, and preoperative examination, in the oriental hepatobiliary surgery hospital affiliated to the second military Medical University. Intraoperative condition, postoperative examination, diagnosis and treatment, etc. Results the diagnosis time of portal vein thrombosis was 3 ~ 15 days (mean 6.6 days). Liver function deteriorated rapidly in 9 patients after operation, which showed that the total bilirubin (TBIL) of alanine aminotransferase (ALT), decreased gradually and then increased suddenly. The TBIL on the day of diagnosis was 159.4 (9.5 卤472.9) 渭 mol / L alt 1175.4 (73.9 卤5485) U/L.6 patients underwent D-dimer examination. Among them, 5 cases (83.3%) were significantly elevated (20 mg/L), 1 case was slightly elevated (鈮，
本文编号：2160059
[Abstract]:Objective to investigate the possible causes and preventive measures of venous thrombosis after hepatectomy for hepatocellular carcinoma (HCC). Methods from January 2010 to December 2013, the data of 10 patients with venous thrombosis after hepatectomy were retrospectively analyzed, including general information, past medical history, and preoperative examination, in the oriental hepatobiliary surgery hospital affiliated to the second military Medical University. Intraoperative condition, postoperative examination, diagnosis and treatment, etc. Results the diagnosis time of portal vein thrombosis was 3 ~ 15 days (mean 6.6 days). Liver function deteriorated rapidly in 9 patients after operation, which showed that the total bilirubin (TBIL) of alanine aminotransferase (ALT), decreased gradually and then increased suddenly. The TBIL on the day of diagnosis was 159.4 (9.5 卤472.9) 渭 mol / L alt 1175.4 (73.9 卤5485) U/L.6 patients underwent D-dimer examination. Among them, 5 cases (83.3%) were significantly elevated (20 mg/L), 1 case was slightly elevated (鈮，
本文编号：2160059
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