CT扫描评估乙型肝炎肝硬化并发脾功能亢进症患者PSE术后门静脉系统血栓形成价值研究*

doi:10.3969/j.issn.1672-5069.2025.05.027

Abstract

Abstract: Objective The aim of this study was to investigate incidence and risk factors of portal venous system thrombosis(PVST)in patients with hepatitis B-induced liver cirrhosis (LC) and hypersplenism after partial splenic artery embolization (PSE). Methods 90 patients with hepatitis B-induced LC with complicated hypersplenism were encountered in our hospital between January 2020 and June 2024, and all underwent PSE for ameliorating decreased peripheral blood cell counts. Abdominal CT scan was routinely carried out. Multivariate Logistic regression analysis was applied to find impacting factors. Results By three months after PSE, PVST was proven by CT scan in 17 cases (18.9%) out of our 90 patients; percentage of patients with intravenous low molecular dextran and low molecularweight heparin administration after operation in patients with PVST were 11.8% and 17.6%, much lower than 37.0% and 42.5%(P<0.05)in those without PVST; diameter of spleen, diameter of portal vein, diameter of splenic vein, diameter of superior mesenteric vein and percentage of splenic embolism area in patients with PVST were all significantly greater than, while blood flow velocity of portal vein was much slower than in those without PVST (P<0.05); multivariate Logistic regression analysis showed thatno anticoagulant intervention, portal vein diameter >1.58 cm, portal vein blood flowvelocity <13.1cm/s and spleen embolism area percentage >39.0% were all independent risk factors for occurrence of PVST after PSE (P<0.05). Conclusion PVST could occur after PSE in patients with hepatitis B-induced LC and complicated hypersplenism, which might be prevented by in time anticoagulation intervention, and appropriate percentage of splenic embolism area.

Key words: Liver cirrhosis, Hypersplenism, Partial splenic artery embolization, Portal venous system thrombosis, CT scan

Wang Huifang, Huang Shiquan, Tian Juan. CT scan for determination of portal vein system thrombosis in patients with hepatitis B cirrhosis and hypersplenism after partial splenic artery embolization[J]. Journal of Practical Hepatology, 2025, 28(5): 747-750.

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CT scan for determination of portal vein system thrombosis in patients with hepatitis B cirrhosis and hypersplenism after partial splenic artery embolization

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