Clinical study of the timing selection of anticoagulant therapy in the prevention of portal venous system thrombosis after splenectomy and devascularization

Objective To study the best time and operating security of anticoagulant therapy in the prevention of portal venous system thrombosis(PVT) for patients underwent splenectomy and porta-azygous devascularization.Methods Ninety patients with liver cirrhosis and portal hypertension who need to have splenectomy and porta-azygous devascularization were randomly divided into three groups.Group A:based on anticoagulation therapy,on the second day after surgery,low molecular weight heparin sodium (LMWHS) was given.Group B:based on anticoagulant therapy,low molecular weight heparin sodium (LMWHS) was given when platelet exceeded 300 × 109/L after operation.Group C:just use the basic anticoagulant therapy.The side effects such as incidence of thrombosis,postoperative hemorrhage were compared.Results The incidence rate of portal venous system thrombosis in group A (3.39％) was obviously lower than that in group B (25.93 ％,P ＜ 0.05) and group C (35.71％,P ＜ 0.05),but there was no significant difference between group B and group C (x2 =0.6167,P ＞ 0.05).There was no side effect during treatment.Conclusions It is better to use anticoagulation therapy early(on the second day after surgery) to prevent the formation of portal vein thrombosis,and it is safe and convenient. Key words: Splenectomy and devascularization ;  Portal vein ;  Thrombosis ;  Prevention ;  Anticoagulation