Anticoagulation Therapy After Splenectomy in Cirrhosis Patient
Condition: Liver Cirrhosis; Portal Hypertension; Anticoagulant-induced Bleeding; Thrombosis
MeSH terms: Liver Cirrhosis; Hypertension, Portal; Hypertension; Thrombosis; Fibrosis
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      1. Inclusion and Exclusion Criteria Inclusion criteria: Inpatients who received laparotomy or
      laparoscopic splenectomy according to clinical, B-ultrasound scan, CT or MRI diagnosis of
      cirrhosis and portal hypertension.

      Exclusion criteria:

        1. ) Portal vein system thrombosis (PVST) found by preoperative color Doppler ultrasound or
           MRI examination;

        2. ) Liver cirrhosis complicated with liver tumor;

        3. ) Liver cirrhosis complicated with blood system diseases;

        4. ) Patients who have not signed the informed consent form.

      2. Research subgroup According to the order of the patients, the following groups are entered
      in turn, and the cycle is repeated.

        1. ) Heparin group

        2. ) Rivaroxaban group

        3. ) Control group.
    

Detailed description: 
      1. Inclusion and Exclusion Criteria Inclusion criteria: Inpatients who received laparotomy or
      laparoscopic splenectomy according to clinical, B-ultrasound scan, CT or MRI diagnosis of
      cirrhosis and portal hypertension.

      Exclusion criteria:

        1. ) Portal vein system thrombosis (PVST) found by preoperative color Doppler ultrasound or
           MRI examination;

        2. ) Liver cirrhosis complicated with liver tumor;

        3. ) Liver cirrhosis complicated with blood system diseases;

        4. ) Patients who have not signed the informed consent form.

      2. Research subgroup According to the order of the patients, the following groups are entered
      in turn, and the cycle is repeated.

        1. ) Heparin group: Low molecular weight heparin 5000U ih Q12h was given 24 hours after
           operation, 5 days after operation. Warfarin 1.25-2.5 mg po qd, 30 days after operation.
           PT（prothrombin time）/INR（international normalized ratio） was kept at 1.25-1.5.

        2. ) Rivaroxaban group: Rivaroxaban 10mg po qd from 24 hours after operation, 30 days after
           operation. PT/INR was kept at 1.25-1.5.

        3. ) Control group: No preventive intervention measures. If platelets in the above groups
           are > 500× 109/L, aspirin 100 mg qd is added for 1 month. If platelets are > 1000×
           109/L, platelet collection is performed.

      3. Monitoring indicators Color Doppler ultrasound was reexamined 1, 2, 3 and 4 weeks after
      operation to find out whether PVST was present. Abdominal CT was performed when PVST was
      suspected. After the patient's condition is stable, the portal vein system ultrasound is
      reviewed monthly, and the follow-up time is 1 year.
    

Intervention name(s): Heparin and Rivaroxaban
Intervention type(s): Drug
Intervention description(s): Low molecular weight heparin 5000U ih Q12h was given 24 hours after operation, 5 days after operation Rivaroxaban 10mg PO QD from 24 hours after operation, 30 days after operation
Other intervention name(s): platelet collection
Intervention MeSH terms: Heparin; Rivaroxaban
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention