肝硬化门静脉高压症外科手术后门静脉血栓形成的危险因素分析-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 肝硬化门静脉高压症外科手术后门静脉 血栓形成的危险因素分析 研究生：赵亮 导师：赵晋明 摘 要 目的：探讨肝硬化门静脉高压症外科手术后门静脉系统血栓形成的相关危险因 素。方法： 回顾分析新疆医科大学第一附属医院 2005 年 1 月至 2010 年 2 月 183 例 肝硬化门静脉高压症行外科手术患者的临床资料，采用卡方检验和二元 Logistic 回 归对可能导致术后门静脉血栓形成的临床相关危险因素进行分析。结果：Logistic 回 归统计结果(χ2＝105.891，P=0.000)显示腹水、门静脉宽度增宽、脾静脉宽度增宽、 肝功能 Child-Pugh 分级差、血小板计数升高、D-二聚体升高是肝硬化门静脉高压症 术后门静脉血栓形成的危险因素（P=0.026、0.038、0.035、0.041、0.012、0.031）。 上述危险因素重要性依次为：血小板计数、腹水、D-二聚体、脾静脉宽度、门静脉 宽度、肝功能 Child-Pugh 分级，Wald 值依次为 16.827、14.815、13.506、9.282、8.665、 4.196，OR 值分别为 2.236、2.056、1.901、1.581、1.342、1.274。结论：肝硬化门静 脉高压症外科术后门静脉血栓的主要的危险因素是腹水、门静脉宽度增宽、脾静脉 宽度增宽、肝功能 Child-Pugh 分级差、血小板计数升高、D-二聚体升高。临床上应 对这类患者予以积极及时的救治。 关键词 肝硬化；高血压；门静脉血栓 新疆医科大学医学硕士学位论文 The analysis on risk factors of portal vein thrombosis in patients of hepatic cirrhosis complicating portal hypertension postoperation Postgraduate:Zhao Liang Supervisor: Prof. Zhao Jinming Abstract Objective To investigate the risk factors of portal vein thrombosis in patients of hepatic cirrhosis complicating portal hypertension postoperation. Methods Clinical data of 183patients with portal hypertension in liver cirrhosis who had operation were reviewed fromJanuary,2005to February, 2010 in The First Affiliated Hospital of Xinjiang Medical University.The data of risk factors which may leding to the portal vein thrombosis were analyzed by χ2 and binary regression .Results Logistic regression model(χ2＝105.891， P=0.000).The order of the importance of each factor was the increase of the platlat,having ascites, the increase of the D-dimer, the increase of the width of spleen vein,the increase of the width of portal vein,the Child-Pugh classfication of liver function,and Wald value was16.827,14.815,13.506,9.282,8.665,4.196;The odds ratio(OR) was 2.236,2.056,1.901, 1.581,1.342,1.274.Conclusion The increase of the platlat,having ascites, the increase of the D-dimer, the increase of the width of spleen vein,the increase of the width of portal vein,the Child-Pugh classfication of liver function are risk fac