Clinical effect of low-molecular-weight heparin in prevention and treatment of liver cirrhosis and portal vein thrombosis after splenectomy: a systematic review and meta-analysis

Abstract

Objective: To investigate the clinical effect of low-molecular-weight heparin (LMWH) in the treatment of liver cirrhosis and portal vein thrombosis and the value of early application of LMWH in the prevention of portal vein thrombosis after splenectomy. Methods: The databases of PubMed, Google Scholar, CNKI, Wanfang Data, and VIP were searched, and manual searching and internet searching were used to retrieve grey literature. The articles which met the inclusion criteria were included, and a systematic review and meta-analysis was performed. Results: A total of 12 randomized controlled trials were included, with 1397 patients enrolled, among whom 723 were enrolled in the LMWH group and 674 were enrolled in the control group. A meta-analysis was performed for the trials above, and the results showed that the patients with early application of LMWH had a lower rate of thrombosis compared with those in the control group (OR = 0.37, 95% CI 0.28-0.48, P < 0.001). The results of three randomized trials with the application of LMWH in the treatment of portal vein embolism showed that the patients treated with LMWH had a higher rate of recanalization of thrombus than those in the control group (OR = 5.08, 95% CI 1.74-14.84, P < 0.001). Conclusion: Early application of LMWH can reduce the rate of portal vein thrombosis after splenectomy, and LMWH for the treatment of portal vein embolism can increase the rate of recanalization of thrombus.