Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension (Br J Surg 2010; 97: 910-916)

Research Progress in Chinese Medicine Preparations for Promoting Blood Circulation and Removing Blood Stasis for Cirrhotic Patients with Portal Vein Thrombosis Following Splenectomy

This article presented an overview of the therapeutic effects of Chinese medicine (CM) preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis (PVT) after splenectomy. Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension (CPH), this paper evaluated the incidence of PVT, and explored potential active components and mechanisms of CM preparations. Safflower Yellow Injection, Danshen Injection () Danhong Injection (), and Compound Danshen Dropping Pill () achieved good curative effect alone or combined with anticoagulant therapy. In addition, Compound Biejia Ruangan Tablet () and Anluo Huaxian Pill () can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis. Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH, we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.

Early joint application of anticoagulant drugs to prevent portal vein thrombosis after splenectomy and devascularization

AIM: To assess the preventive effects of early joint application of anticoagulant drugs on portal vein thrombosis after splenectomy and devascularization and to explore the possible mechanism

METHODS: One hundred and twenty-eight patients with portal hypertension who underwent splenectomy and devascularization were included, including 28 patients with early application of low molecular heparin calcium (heparin group), 42 with joint application of low molecular heparin calcium and low molecular dextran (joint group), and 58 without the use of anticoagulant drugs (control group). The rate of postoperative thrombosis, postoperative platelet count, and prothrombin time (PT) were compared among the three groups. The indexes of portal vein blood flow were also recorded.

RESULTS: One month after surgery, portal vein thrombosis developed in 5 (8.57%) cases in the heparin group, in 1 (2.38%) case in the joint group, and in 14 (24.13%) cases in the control group. The rate of postoperative portal vein thrombosis was significantly higher in the control group than in the heparin group (P < 0.05), and in the heparin group than in the joint group (P < 0.05).

CONCLUSION: Early anticoagulation use can effectively prevent the formation of portal vein thrombosis after splenectomy, and combined use of low molecular heparin calcium and low molecular dextran has better effects.