Dextranum in Combination with Low-Molecular-Weight Heparin Prevents the Portal Vein Thrombosis after Splenectomy for Portal Hypertension

Abstract

This study aimed to explore the effect of dextranum in combination with low-molecular-weight heparin on the prevention of portal vein thrombosis after splenectomy for portal hypertension. Between February 2015 and February 2019, we enrolled 128 liver cirrhosis patients with portal hypertension as the subjects which were later divided randomly into the observation group and the control group, with 64 patients in each group. All patients received the splenectomy in combination with the esophagogastric devascularization. Following the surgery, dextranum was given to the patients in two groups for prevention of portal vein thrombosis, while those in the observation would additionally took low-molecular-weight heparin for prophylaxis of portal vein thrombosis. After medication, incidence of portal vein thrombosis after surgery was recorded, and at 1 d and 14 d after surgery, the platelet count in peripheral blood was also detected; furthermore, we recorded the condition of patients in preventive anti-coagulation treatment, oral administration of enteric-coated aspirin, postoperative hospitalization days and the incidence of complications, including gastrointestinal bleeding and liver failure, within 3 mo after operation. In the observation group, the incidence rate of postoperative portal vein thrombosis was 9.37 %, significantly lower than 31.25 % in the control group (p<0.05), while the difference in the platelet count test at 1 d after operation showed no statistical significance (p>0.05), and the platelet count test showed an increasing trend at 14 d after operation (p<0.05); however, the intergroup comparison showed no significant difference (p>0.05). Between two groups, the duration of preventive anti-coagulation treatment and oral administration of aspirin showed no significant difference (p>0.05), while the patients had a shorter hospitalization duration in the observation group than their counterparts in the control group (p<0.05). Within 3 mo after operation, the incidence rate of complications, including gastrointestinal bleeding and liver failure, in the observation group was 6.25 %, significantly lower than 26.56 % in the control group (p<0.05). After splenectomy for portal hypertension, dextranum in combination with the low-molecularweight heparin can prevent the portal vein thrombosis by inhibiting the platelet aggregation, thereby promoting the patients’ recovery and decreasing the incidence of postoperative complications.