Abstract: Objective To investigate the efficacy and safety of anticoagulation therapy for portal vein thrombosis (PVT) after splenectomy in cirrhosis patients. Methods A total of 106 cirrhosis patients admitted to our hospital from December 2015 to June 2019 who underwent splenectomy were enrolled. They were randomly divided into control group (50 cases) and experimental group (56 cases). Patients in experimental group were treated with low molecular heparin (subcutaneous injection, once a day for a week) combined with warfarin (oral administration, 24 weeks) 24 hours after splenectomy, while the control group received no anticoagulation therapy after splenectomy. The rate of PVT, liver function index, Child-Pugh score, diameter of portal vein (Dpv), velocity of portal vein (Vpv), complication rates and average hospitalization time of 2 groups were compared. Results The rates of PVT in experimental group and control group were 16.1% and 44% in 2 weeks after splenectomy, 12.5% and 40.0% in 4 weeks after splenectomy, 8.9% and 38.0% in 12 weeks after splenectomy, 7.1% and 34.0% in 24 weeks after splenectomy, 7.1% and 32.0% in 48 weeks after splenectomy, respectively. The levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT) and Child-Pugh score of experimental group in week 2, 4, 12, 24 and 48 after splenectomy were significantly lower than those of control group (P<0.05), respectively. The Dpv of experimental group was wider than that of control group, and the Vpv of experimental group was faster than that of control group in week 2, 4, 12, 24 and 48, P<0.05. At week 48, the rates of alimentary tract hemorrhage of experimental group and control group were 3.6% and 10.0% (P>0.05), the rates of hepatic encephalopathy of the 2 groups were1.8% and 8.0% (P>0.05), the rates of intestinal necrosis of the 2 groups were 1.8% and 6.0% (P>0.05), the rates of ascites of the 2 groups were 14.3% and 32.0% (P<0.05). The average hospitalization time of experimental group (10.8 ± 2.9 days) was significantly shorter than that of control group (15.9 ± 4.6 days), P<0.05. No obvious adverse reaction was observed during the period of anticoagulation therapy. Conclusion Anticoagulation therapy can effectively reduce PVT risk after splenectomy in cirrhosis patients, with satisfactory safety.

Key words: Liver cirrhosis, Splenectomy, Anticoagulation therapy, Portal vein thrombosis, Safety