[Effects of alprostadil in prevention of portal vein thrombogenesis after splenectomy and devascularization: a clinical observation of 76 patients with portal hypertension].
OBJECTIVE
To investigate the effects of alprostadil (Lipo PGE1) in prevention of portal vein thrombogenesis (PVT) after splenectomy for portal hypertension.


METHODS
Seventy-six patients with portal hypertension undergoing splenectomy and pericardial devascularization were randomly divided into 2 groups :treatment group (n = 40), receiving intravenous drip of injection of radix Salviae miliorrhazae (RSM) 40 ml and alprostadil 20 microg, both once a day since the third day after operation for 2 weeks and then oral administration of dropping pill of SM, and control group (n = 36), receiving intravenous drip of injection of RSM and taking enteric coated aspirin 3 times a day for 2 weeks and then taking dropping pill of SM. Platelets (PLT), prothrombin time (PT), and liver function were detected periodically. Color Doppler ultrasonography was conducted every week to observe the blood flow velocity and diameter of the portal and splenic veins, and if PVT event and ascites occurred. All patients were followed up for 8 - 20 months.


RESULTS
No prolongation of coagulation time and bleeding tendency was found in both groups. The PLT number increased remarkably in the 7th to 14th days after operation without significant difference between the 2 groups (P >0.05). The PVT rate of the treatment group was 5.0%, significantly lower than that of the control group (25.0%, chi2 = 6.12, P < 0.05). The ascites rate of the treatment group was 10.0%, significantly lower than that of the control group (33.3%, chi2 = 7.44, P <0.01). The levels of ALT and total bilirubin 7 and 16 days after operation of the treatment group were all significantly lower than those of the control group (all P <0.05).


CONCLUSIONS
Use of alprostadil early after devascularization is an effective and safe measure to prevent PVT, improve liver function, and decrease ascites rate.
Ma
Jian-Cang
JC
Department of General Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China. majiancang@126.com
Zhao
Jun
J
Su
Qing-Hua
QH
Zhang
Da-Hua
DH
Guo
Ying
Y
Ji
Zong-Zheng
ZZ
D000527:Alprostadil / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008099:Liver / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D011169:Portal Vein / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D027561:Salvia miltiorrhiza / Q000737:chemistry; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D004365:Drugs, Chinese Herbal; D014665:Vasodilator Agents; D000527:Alprostadil