肠系膜静脉血栓诊治(附11例病例分析)

目的 总结肠系膜静脉血栓临床诊治方法。方法 回顾性分析北京协和医院1992-2001年收治的11例肠系膜静脉血栓病例。结果 腹部手术(尤其是肝硬化和门脉高压)(27．3％)及血栓史(27．3％)是主要诱发因素,11例患者中2例行早期溶栓治疗,治愈;另9例在外院误诊而来本院后手术。无术后死亡,术后复发1例(11．1％)。结论 对于具有可能导致肠系膜静脉血栓危险因素的患者及早开始抗凝治疗十分必要。对于可疑病例应及早行CT检查 血管造影,明确诊断后积极抗凝、溶栓治疗可有效避免肠管切除。术后维持相应时间的抗凝可减少血栓复发。

Diagnosis and treatment of mesenteric venous thrombosis: analysis of eleven cases

Objective To evaluate the diagnosis and treatment of mesenteric venous thrombosis. Methods The clinical data of 11 cases diagnosed as mesenteric venous thrombosis between 1992 and 2001 in PUMC Hospital were analyzed retrospectively. Results Postoperative state(27.3%), especially cirrhosis and portal hypertension, and other history of thrombosis (27.3%) were the most common causes. Thrombolysis was performed successfully in two of the eleven cases. The rest of them were misdiagnosed in other hospitals and operated. No patient died after operation, and one (11.1%) recurrence was found. Conclusions Early application of anticoagulant is necessary for patients with thrombosis risks. For suspected patients, early computed tomography (CT) and DSA examination should be performed, and prompt thrombolysis and anticoagulation therapy can be performed to avoid the bowel resection after definite diagnosis. To reduce the recurrence, anticoagulant should be maintained for a proper time.