阿司匹林早期直肠给药在肝硬化门静脉高压症术后的应用效果
|
摘要
目的评价阿司匹林栓早期经直肠给药预防肝硬化门静脉高压症(PTH)术后门静脉血栓(PVT)形成的效果。方法选取我院2015年8月至2017年12月收治的肝硬化PTH行脾切断流术的80例患者为研究对象,将其随机分为对照组(40例)和试验组(40例)。试验组术后给予阿司匹林栓0.1 g/d,对照组术后连续观察7 d,不预防应用抗聚集治疗,7 d后两组患者均给予常规化治疗。比较两组治疗效果。结果两组患者的TEG显示,术后3、7 d,试验组患者的MA低于对照组(P<0.05)。试验组患者的术后PVT形成比例明显低于对照组(P<0.05)。结论阿司匹林栓早期经直肠给药,在肠道功能恢复后再行常规化治疗,是预防肝硬化PTH术后PVT形成的有效方法。
Objective To evaluate the efficacy of early rectal administration of aspirin suppository on portal vein thrombosis(PVT) after operation for cirrhosis and portal hypertension(PTH). Methods Eighty patients with cirrhosis and PTH undergoing splenectomy and drainage admitted in our hospital from August 2015 to December 2017 were selected as the study objects, patients were randomly divided into control group(40 cases) and the experimental group(40 cases). The experimental group was given aspirin suppository 0.1 g/d after operation; the control group was observed continuously for 7 days after operation, and the anti-aggregation therapy was not prevented. Both groups were given routine treatment after 7 days. The therapeutic effects of the two groups were compared. Results The TEG results of the two groups showed that the MA of the experimental group at 3 and 7 d after operation were lower than those of the control group(P <0.05). The proportion of PVT formation in the experimental group was significantly lower than that in the control group(P <0.05).Conclusion Giving early rectal administration of aspirin suppository, and givein routine treatment after intestinal function recovery is an effective method on prevention of PVT after operation for cirrhosis and PTH.
Objective To evaluate the efficacy of early rectal administration of aspirin suppository on portal vein thrombosis(PVT) after operation for cirrhosis and portal hypertension(PTH). Methods Eighty patients with cirrhosis and PTH undergoing splenectomy and drainage admitted in our hospital from August 2015 to December 2017 were selected as the study objects, patients were randomly divided into control group(40 cases) and the experimental group(40 cases). The experimental group was given aspirin suppository 0.1 g/d after operation; the control group was observed continuously for 7 days after operation, and the anti-aggregation therapy was not prevented. Both groups were given routine treatment after 7 days. The therapeutic effects of the two groups were compared. Results The TEG results of the two groups showed that the MA of the experimental group at 3 and 7 d after operation were lower than those of the control group(P <0.05). The proportion of PVT formation in the experimental group was significantly lower than that in the control group(P <0.05).Conclusion Giving early rectal administration of aspirin suppository, and givein routine treatment after intestinal function recovery is an effective method on prevention of PVT after operation for cirrhosis and PTH.
引文
[1]CHAWLA YK,BODH V.Portal vein thrombosis[J].J Clin Exp Hepatol,2015,5(1):22-40.
[2]SHASHA H,FANGPING H.Predictive model of portal venous system thrombosis in cirrhotic portal hypertensive patients after splenectomy[J].Int J Clin Exp Med,2015,8(3):4236-4242.
[3]FERREIRA FG,CHIN EW,SANTOS MF,et al.Portal congestion and thrombosis after esophagogastric devascularization and splenectomy[J].Rev Assoc Med Bras,2005,51(4):233-236.
[4]WEI YH,CHEN XD,ZHANG SY,et al.P-Selectin level at first and third day after portal hypertensive splenectomy for early prediction of portal vein thrombosis in patients with cirrhosis[J].Clin Appl ThrombHemost,2018.
[5]GNANENTHIRAN SR,YIANNIKAS J,LOWE HC,et al.Aspirin hypersensitivity in patients with coronary artery disease:linking pathophysiology to clinical practice[J].Am Heart J,2018,203:74-81.
[6]李伟玲.阿司匹林联合替罗非班预防冠心病PCI术后血栓形成100例分析[J].陕西医学杂志,2017,46(1):112-114.
[7]谢星辉,顾林金,黄胜炎,周桂兰,奚蓓义.阿司匹林栓剂直肠吸收的生物利用度试验[J].中国医药工业杂志,1981,12(2):9-15,56.
[8]汪建辉,杨丽,戴小平.复方丹参滴丸联合阿司匹林肠溶片在门脉高压症术后的应用[J].江西医药,2015,62(8):775-777.
[9]YOSHIDA D,NAGAO Y,TOMIKAWA M,et al.Predictive factors for platelet count after laparoscopic splenectomy in cirrhotic patients[J].Hepatol Int,2012,6(3):657-661.
[10]ZHOU JB,LUO BY,LIU CW,et al.Effects of early antiplatelet therapy after splenectomy with gastro‐oesophageal devascularization[J].ANZ J Surg,2018,88(10):E725-E729.
[11]SUEN K,WESTH RN,CHURILOV L,et al.Low-molecular-weight heparin and the relative risk of surgical site bleeding complications:results of a systematic review and meta-analysis of randomized controlled trials of venous thromboprophylaxis in patients after total joint arthroplasty[J].J Arthroplasty,2017,32(9):2911-2919.
[12]QI X,BAI M,GUO X,et al.Pharmacologic prophylaxis of portal venous system thrombosis after splenectomy:a meta-analysis[J].Gastroenterol Res Pract,2014,2014:292689.
[2]SHASHA H,FANGPING H.Predictive model of portal venous system thrombosis in cirrhotic portal hypertensive patients after splenectomy[J].Int J Clin Exp Med,2015,8(3):4236-4242.
[3]FERREIRA FG,CHIN EW,SANTOS MF,et al.Portal congestion and thrombosis after esophagogastric devascularization and splenectomy[J].Rev Assoc Med Bras,2005,51(4):233-236.
[4]WEI YH,CHEN XD,ZHANG SY,et al.P-Selectin level at first and third day after portal hypertensive splenectomy for early prediction of portal vein thrombosis in patients with cirrhosis[J].Clin Appl ThrombHemost,2018.
[5]GNANENTHIRAN SR,YIANNIKAS J,LOWE HC,et al.Aspirin hypersensitivity in patients with coronary artery disease:linking pathophysiology to clinical practice[J].Am Heart J,2018,203:74-81.
[6]李伟玲.阿司匹林联合替罗非班预防冠心病PCI术后血栓形成100例分析[J].陕西医学杂志,2017,46(1):112-114.
[7]谢星辉,顾林金,黄胜炎,周桂兰,奚蓓义.阿司匹林栓剂直肠吸收的生物利用度试验[J].中国医药工业杂志,1981,12(2):9-15,56.
[8]汪建辉,杨丽,戴小平.复方丹参滴丸联合阿司匹林肠溶片在门脉高压症术后的应用[J].江西医药,2015,62(8):775-777.
[9]YOSHIDA D,NAGAO Y,TOMIKAWA M,et al.Predictive factors for platelet count after laparoscopic splenectomy in cirrhotic patients[J].Hepatol Int,2012,6(3):657-661.
[10]ZHOU JB,LUO BY,LIU CW,et al.Effects of early antiplatelet therapy after splenectomy with gastro‐oesophageal devascularization[J].ANZ J Surg,2018,88(10):E725-E729.
[11]SUEN K,WESTH RN,CHURILOV L,et al.Low-molecular-weight heparin and the relative risk of surgical site bleeding complications:results of a systematic review and meta-analysis of randomized controlled trials of venous thromboprophylaxis in patients after total joint arthroplasty[J].J Arthroplasty,2017,32(9):2911-2919.
[12]QI X,BAI M,GUO X,et al.Pharmacologic prophylaxis of portal venous system thrombosis after splenectomy:a meta-analysis[J].Gastroenterol Res Pract,2014,2014:292689.