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[目的]探讨低分子肝素钙应用时机对门静脉高压(PH)脾切除术后门静脉血栓(PV T)发生的影响.[方法]选取2015年1月至2016年12月本院收治的66例行脾切除手术的PH患者作为研究对象,根据随机数表法将其随机分为A组和B组,每组各33例.A组患者在术后早期即联合应用低分子肝素钙和低分子右旋糖酐进行预防性抗凝治疗,B组患者术后即应用低分子右旋糖酐,待血小板(PL T)计数>100×109/L时联用低分子肝素钙.比较两组的PV T 发生情况和止、凝血功能变化,并记录两组出血发生情况.[结果]66例患者在术后2周内共出现20例PV T,总发生率为30.3%.A组术后PVT 的发生率为18.2%(6/66)显著低于B组的42.4%(14/66),差异有统计学意义(P<0.05).两组患者术后d3、d7、d14的PL T计数显著高于d1,差异具有统计学意义(P0.05).所有患者均未出现皮肤瘀血、瘀斑、血尿、便血等表现.[结论]早期联合应用低分子肝素钙和低分子右旋糖酐可有效预防PH患者脾切除术后PV T的形成,其效果优于中期应用者,且安全可靠,值得临床推广应用.“,”[Objective]To investigate the effect of low molecular weight heparin calcium on the occurrence of portal vein thrombosis(PVT)after splenectomy in patients with portal hypertension(PH).[Methods]Sixty-six patients with PH underwent splenectomy from January 2015 to December 2016 in our hospital were enrolled for the study and randomly divided into group A and group B,33 cases in each group.Patients in the group A were treated with low-molecular-weight heparin and low molecular dextran combined anticoagulant therapy at the early postoperative stage.The group B received low-molecular-weight dextran after operation.When the platelet count(PLT)counts were more than 100×109/L,low molecular weight heparin calcium was used. The incidence of PVT,hemostasis and coagulation function were compared between the two groups.The bleeding was recorded in both groups.[Results]There were 20 cases of PVT in 66 patients within 2 weeks after operation,the total incidence was 30.3%.The incidence of PVT in the group A 18.2%(6 /66)was significant-ly lower than that in the group B 42.4%(14 /66),the difference was statistically significant(P <0.05).The PLT count of the two groups on d3、d7、d14was significantly higher than that on the d1,the difference is statis-tically significant(P 0.05).No skin con-gestion,ecchymosis,hematuria,blood stool were found in all patients.[Conclusion]Early combination of low molecular weight heparin calcium and low molecular dextran can effectively prevent the formation of PVT after splenectomy in patients with PH.Its effect is superior to that of medium-term application,and it is safe and reliable.It is worth popularizing in clinic.