Perioperative Application of Vitamin K<sub>1</sub> after Splenectomy Combined with The Hydro- dynamic Vein Cut-Out in Treatment of Cirrhosis Combined with Portal Hypertension_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENQi ,  WANGFeng , ZONGGuang-quan , ZHANGYu-fei , LIURen-min , QINJia-wei

Department of General Surgery, Bayi Hospital Affiliated Nanjing University of Chinese Medicine, Nanjing 210002, Jiangsu Province, China;

Corresponding?author：

WANGFeng, Email: wf4025136@sina.com

Keywords：

Vitamin K₁; Carbazochrome sodium sulfonate; Cirrhosis; Portal hypertension; Surgical treatment

DOI：

10.7507/1007-9424.20160182

Video：

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Objective To investigate the effect of vitamin K₁ in the function of blood coagulation state, intraopera- tive blood loss, and hemoglobin content of liquid in postoperative drainage in patients with cirrhosis combined with portal hypertension before and after splenectomy combined with the hydrodynamic vein cut-out surgery. Methods In total of 143 cases of cirrhosis combined with portal hypertension who treated in our hospital from January 2010 to October 2015 were prospectively collected, and randomly divided into 3 group, including 51 cases of vitamin K₁ group, 45 cases of carbazochrome sodium sulfonate group, and 47 cases of control group. Drug was used form 1 week before surgery to 5 days after surgery (vitamin K₁ group: vitamin K₁, 0.03 g, intravenous drip; card collaterals sodium sulfonic group: card collaterals sulfonic sodium, 80 mg, intravenous drip; control group: normal saline, 250 mL, intravenous drip). Prothrombin time of patients in 3 groups was detected at 1 week before surgery, 3 days before surgery, 1 day before surgery, 1 day after surgery, 3 days after surgery, and 5 days after surgery; hemoglobin content of liquid in postoperative drainage was detected on 1, 3, and 5 days after surgery. Results In terms of prothrombin time, there was no significant difference at 1 week before surgery and 5 days after surgery (P>0.05); prothrombin time of vitamin K₁ group was lower than those of carbazochrome sodium sulfonate group and control group on 3 days and 1 day before surgery (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and control group on 3 days and 1 day before surgery (P>0.05); prothrombin time of vitamin K₁ group and carbazochrome sodium sulfonate group was both lower than that of control group on 1 day and 3 days after surgery (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and vitamin K₁ group on 1 day and 3 days after surgery (P>0.05). In terms of intraoperative blood loss, intraoperative blood loss of vitamin K₁ group was lower than those of carbazochrome sodium sulfonate group and control group (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and control group (P>0.05). In terms of hemoglobin content of liquid in postoperative drainage, it was lower in vitamin K₁ group and carbazochrome sodium sulfonate group than that of control group on 1 day and 3 days after surgery (P＜0.05), but there was no significant difference among 3 groups on 5 days after surgery (P>0.05). Conclusion Vitamin K₁ is helpful to improve function state of blood coagulation before and after surgery in patients with cirrhosis combined with portal hypertension (from 1 week before surgery to 3 days after surgery), and reduce the intraoperative blood loss; carbazochrome sodium sulfonate can improve function status of postoperative blood coagulation to 3 days after surgery and postoperative blood loss, but has no obvious improvement in the function status of preoperative blood coagulation and introperative blood loss.

Citation： CHENQi, WANGFeng, ZONGGuang-quan, ZHANGYu-fei, LIURen-min, QINJia-wei. Perioperative Application of Vitamin K₁ after Splenectomy Combined with The Hydro- dynamic Vein Cut-Out in Treatment of Cirrhosis Combined with Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 682-686. doi: 10.7507/1007-9424.20160182 Copy

1.	?Wang SL, Zhu XY, Zhang DW, et al. Relevance of plasma malondial-dehyde level and severity of portal hypertension in cirrhotic patients. Int J Clin Exp Med, 2015, 8(7): 11007-11013.
2.	Lake-Bakaar G, Ahmed M, Evenson A, et al. Hagen-Poiseuille’s law: the link between cirrhosis, liver stiffness, portal hypertension and hepatic decompensation. World J Hepatol, 2015, 7(1): 28-32.
3.	王東, 栗光明, 朱繼業, 等. 保脾斷流術治療門靜脈高壓癥上消化道出血的療效分析. 中國普外基礎與臨床雜志, 2013, 20(1): 29-32.
4.	許永慶, 戴朝六, 卜獻民, 等. 門靜脈高壓癥上消化道出血行急診斷流術的治療體會. 中國普外基礎與臨床雜志, 2013, 20(1): 33-36.
5.	Lu H, Liu S, Zhang Y, et al. Therapeutic effects and complications of simplified pericardial devascularization for patients with portal hypertension. Int J Clin Exp Med, 2015, 8(8): 14036-14041.
6.	Barakat AA, Metwaly AA, Nasr FM, et al. Impact of hyponatremia on frequency of complications in patients with decompensated liver cirrhosis. Electron Physician, 2015, 7(6): 1349-1358.
7.	Zhang DY, Weng SQ, Dong L, et al. Portal hypertension induced by congenital hepatic arterioportal fistula: report of four clinical cases and review of the literature. World J Gastroenterol, 2015, 21(7): 2229-2235.
8.	Berzigotti A, De Gottardi A, Vukotic R, et al. Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension. PLoS One, 2013, 8(3): e58742.
9.	Tanaka T, Sugawara Y, Kokudo N. The current clinical aspects of idiopathic portal hypertension. Intractable Rare Dis Res, 2013, 2(3): 94-97.
10.	Zhu X, Han W, Wang L, et al. Penicillar arterioles of red pulp in residual spleen after subtotal splenectomy due to splenomegaly in cirrhotic patients: a comparative study. Int J Clin Exp Pathol, 2015, 8(1): 711-718.
11.	Chu H, Liu X, Zhao J, et al. Subtotal splenectomy for splenomegaly in cirrhotic patients. Int J Clin Exp Pathol, 2014, 7(8): 4981-4990.
12.	Müller M, Seufferlein T, Perkhofer L, et al. Self-expandable metal stents for persisting esophageal variceal bleeding after band ligation or injection-therapy: a retrospective study. PLoS One, 2015, 10(6): e0126525.
13.	Ali Hussein AE, Mahfouz H, Elazeem KA, et al. The value of U/S to determine priority for upper gastrointestinal endoscopy in emergency room. Medicine (Baltimore), 2015, 94(49): e2241.
14.	Li L, Gou CY, Li J, et al. Cancer of the Liver Italian Program score helps identify potential candidates for transarterial chemoemboliza-tion in patients with Barcelona Clinic Liver Cancer stage C. Hepato-biliary Pancreat Dis Int, 2016, 15(2): 152-157.
15.	Yamakado K, Hirota S. Sub-classification of intermediate-stage (Barcelona Clinic Liver Cancer stage-B) hepatocellular carcinomas. World J Gastroenterol, 2015, 21(37): 10604-10608.
16.	王明, 文天夫, 嚴律南, 等. 肝硬變肝功Child A級患者行肝移植或脾切除門奇斷流術的療效比較. 中國普外基礎與臨床雜志, 2013, 20(1): 18-23.
17.	俞軍, 張武, 張珉, 等. 肝移植治療門靜脈高壓上消化道出血的療效分析. 中國普外基礎與臨床雜志, 2013, 20(1): 24-28.
18.	竇磊, 劉洪亮, 宿寶棟, 等. 門靜脈高壓癥切脾術式原位法和傳統法的對比研究. 腹部外科, 2014, 27(3): 207-209.
19.	Dinicolantonio JJ, Bhutani J, O’Keefe JH. The health benefits of vitamin K. Open Heart, 2015, 2(1): e000300.
20.	Teitelbaum AM, Scian M, Nelson WL, et al. Efficient syntheses of vitamin K chain-shortened acid metabolites. Synthesis (Stuttg), 2015, 47(7): 944-948.
21.	Lee HJ, You MR, Moon WR, et al. Evaluation of risk factors in patients with vitamin K-dependent coagulopathy presumed to be caused by exposure to brodifacoum. Korean J Intern Med, 2014, 29(4): 498-508.
22.	Philip J, Sarkar RS, Pathak A. The effect of repeated freezing and thawing on levels of vitamin K-dependent coagulation factors and fibrinogen in fresh frozen plasma. Asian J Transfus Sci, 2013, 7(1): 11-15.
23.	Campani V, Marchese D, Pitaro MT, et al. Development of a liposome-based formulation for vitamin K₁ nebulization on the skin. Int J Nanomedicine, 2014, 9: 1823-1832.
24.	Beulens JW, Booth SL, van den Heuvel EG, et al. The role of mena-quinones (vitamin K2) in human health. Br J Nutr, 2013, 110(8): 1357-1368.
25.	El Asmar MS, Naoum JJ, Arbid EJ. Vitamin k dependent proteins and the role of vitamin K2 in the modulation of vascular calcification:a review. Oman Med J, 2014, 29(3): 172-177.
26.	Oh-oka H, Yamada T, Noto H, et al. Effect of carbazochrome sodium sulfonate on refractory chronic prostatitis. Int J Urol, 2014, 21(11): 1162-1166.
27.	Gan XJ, Liu SP, Liu ZF, et al. Fluorescence quenching method for the determination of carbazochrome sodium sulfonate with aromatic amino acids. Luminescence, 2013, 28(3): 265-269.
28.	陳啟, 宗光全, 王峰, 等. 損傷控制理念在門脈高壓癥合并肝癌外科治療中的應用. 東南國防醫藥, 2015, 17(5): 531-533.

1. ?Wang SL, Zhu XY, Zhang DW, et al. Relevance of plasma malondial-dehyde level and severity of portal hypertension in cirrhotic patients. Int J Clin Exp Med, 2015, 8(7): 11007-11013.
2. Lake-Bakaar G, Ahmed M, Evenson A, et al. Hagen-Poiseuille’s law: the link between cirrhosis, liver stiffness, portal hypertension and hepatic decompensation. World J Hepatol, 2015, 7(1): 28-32.
3. 王東, 栗光明, 朱繼業, 等. 保脾斷流術治療門靜脈高壓癥上消化道出血的療效分析. 中國普外基礎與臨床雜志, 2013, 20(1): 29-32.
4. 許永慶, 戴朝六, 卜獻民, 等. 門靜脈高壓癥上消化道出血行急診斷流術的治療體會. 中國普外基礎與臨床雜志, 2013, 20(1): 33-36.
5. Lu H, Liu S, Zhang Y, et al. Therapeutic effects and complications of simplified pericardial devascularization for patients with portal hypertension. Int J Clin Exp Med, 2015, 8(8): 14036-14041.
6. Barakat AA, Metwaly AA, Nasr FM, et al. Impact of hyponatremia on frequency of complications in patients with decompensated liver cirrhosis. Electron Physician, 2015, 7(6): 1349-1358.
7. Zhang DY, Weng SQ, Dong L, et al. Portal hypertension induced by congenital hepatic arterioportal fistula: report of four clinical cases and review of the literature. World J Gastroenterol, 2015, 21(7): 2229-2235.
8. Berzigotti A, De Gottardi A, Vukotic R, et al. Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension. PLoS One, 2013, 8(3): e58742.
9. Tanaka T, Sugawara Y, Kokudo N. The current clinical aspects of idiopathic portal hypertension. Intractable Rare Dis Res, 2013, 2(3): 94-97.
10. Zhu X, Han W, Wang L, et al. Penicillar arterioles of red pulp in residual spleen after subtotal splenectomy due to splenomegaly in cirrhotic patients: a comparative study. Int J Clin Exp Pathol, 2015, 8(1): 711-718.
11. Chu H, Liu X, Zhao J, et al. Subtotal splenectomy for splenomegaly in cirrhotic patients. Int J Clin Exp Pathol, 2014, 7(8): 4981-4990.
12. Müller M, Seufferlein T, Perkhofer L, et al. Self-expandable metal stents for persisting esophageal variceal bleeding after band ligation or injection-therapy: a retrospective study. PLoS One, 2015, 10(6): e0126525.
13. Ali Hussein AE, Mahfouz H, Elazeem KA, et al. The value of U/S to determine priority for upper gastrointestinal endoscopy in emergency room. Medicine (Baltimore), 2015, 94(49): e2241.
14. Li L, Gou CY, Li J, et al. Cancer of the Liver Italian Program score helps identify potential candidates for transarterial chemoemboliza-tion in patients with Barcelona Clinic Liver Cancer stage C. Hepato-biliary Pancreat Dis Int, 2016, 15(2): 152-157.
15. Yamakado K, Hirota S. Sub-classification of intermediate-stage (Barcelona Clinic Liver Cancer stage-B) hepatocellular carcinomas. World J Gastroenterol, 2015, 21(37): 10604-10608.
16. 王明, 文天夫, 嚴律南, 等. 肝硬變肝功Child A級患者行肝移植或脾切除門奇斷流術的療效比較. 中國普外基礎與臨床雜志, 2013, 20(1): 18-23.
17. 俞軍, 張武, 張珉, 等. 肝移植治療門靜脈高壓上消化道出血的療效分析. 中國普外基礎與臨床雜志, 2013, 20(1): 24-28.
18. 竇磊, 劉洪亮, 宿寶棟, 等. 門靜脈高壓癥切脾術式原位法和傳統法的對比研究. 腹部外科, 2014, 27(3): 207-209.
19. Dinicolantonio JJ, Bhutani J, O’Keefe JH. The health benefits of vitamin K. Open Heart, 2015, 2(1): e000300.
20. Teitelbaum AM, Scian M, Nelson WL, et al. Efficient syntheses of vitamin K chain-shortened acid metabolites. Synthesis (Stuttg), 2015, 47(7): 944-948.
21. Lee HJ, You MR, Moon WR, et al. Evaluation of risk factors in patients with vitamin K-dependent coagulopathy presumed to be caused by exposure to brodifacoum. Korean J Intern Med, 2014, 29(4): 498-508.
22. Philip J, Sarkar RS, Pathak A. The effect of repeated freezing and thawing on levels of vitamin K-dependent coagulation factors and fibrinogen in fresh frozen plasma. Asian J Transfus Sci, 2013, 7(1): 11-15.
23. Campani V, Marchese D, Pitaro MT, et al. Development of a liposome-based formulation for vitamin K₁ nebulization on the skin. Int J Nanomedicine, 2014, 9: 1823-1832.
24. Beulens JW, Booth SL, van den Heuvel EG, et al. The role of mena-quinones (vitamin K2) in human health. Br J Nutr, 2013, 110(8): 1357-1368.
25. El Asmar MS, Naoum JJ, Arbid EJ. Vitamin k dependent proteins and the role of vitamin K2 in the modulation of vascular calcification:a review. Oman Med J, 2014, 29(3): 172-177.
26. Oh-oka H, Yamada T, Noto H, et al. Effect of carbazochrome sodium sulfonate on refractory chronic prostatitis. Int J Urol, 2014, 21(11): 1162-1166.
27. Gan XJ, Liu SP, Liu ZF, et al. Fluorescence quenching method for the determination of carbazochrome sodium sulfonate with aromatic amino acids. Luminescence, 2013, 28(3): 265-269.
28. 陳啟, 宗光全, 王峰, 等. 損傷控制理念在門脈高壓癥合并肝癌外科治療中的應用. 東南國防醫藥, 2015, 17(5): 531-533.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Perioperative Application of Vitamin K₁ after Splenectomy Combined with The Hydro- dynamic Vein Cut-Out in Treatment of Cirrhosis Combined with Portal Hypertension

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Perioperative Application of Vitamin K1 after Splenectomy Combined with The Hydro- dynamic Vein Cut-Out in Treatment of Cirrhosis Combined with Portal Hypertension

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Perioperative Application of Vitamin K₁ after Splenectomy Combined with The Hydro- dynamic Vein Cut-Out in Treatment of Cirrhosis Combined with Portal Hypertension