肠系膜静脉血栓形成8例治疗体会

为提高肠系膜静脉血栓形成的诊治经验，回顾性分析近12年来收治的肠系膜静脉血栓8例的临床资料。该病临床表现缺乏特异性，易误诊。8例均经手术探查获得确诊。术中见肠系膜血管内有大小不等条索状黑色血栓，小肠不同程度的缺血坏死，均行受累肠管及系膜切除、肠管端端吻合术。术后均辅以抗凝治疗。结果7例治愈，1例死亡。提示：肠切除加术后辅以抗凝治疗是防止复发、提高生存率、降低病死率的关键。     

急性肠系膜静脉血栓形成的诊治体会

目的探讨肠系膜静脉血栓形成(Mesenteric venous thrombosis)的诊断及治疗。方法分析7例急性肠系膜静脉血栓形成的临床表现、实验室及影像学检查和术中所见、病理等。结果7例患者均急诊行剖腹探查，术中发现肠系膜静脉部分栓塞，均行部分小肠切除术。结论肠系膜静脉血栓形成的早期诊断较为困难，CT与血管造影较为敏感。对高度怀疑本病或有腹膜炎体征者，应立即剖腹探查，切除坏死肠管。     

门奇断流术后肠系膜静脉血栓形成6例报告

门奇断流术后肠系膜静脉血栓形成（ＭＶＴ）,是一种少见的并发症,我们近年来收治６例,报道如下。１临床资料自１９８７～１９９６年,收治门奇断流术后ＭＶＴ病人６例,男３例,女３例,年龄２３～５８岁,平均４０５岁。６例皆因肝硬化门脉高压症并上消化道出血而实...     

急性肠系膜上静脉血栓形成12例诊治体会

作者通过回顾性总结临床资料探讨了急性肠系膜上静脉血栓形成的病因及治疗。自１９７８－１９９５年作者所在单位共施治１２例急性肠系膜上静脉血栓形成，男生９例，女性３例，男女比例为３；１。发病年龄自２１－６４岁，平均３９．４岁。６例伴有门静脉高压，４例曾行脾切除，４例合并血液高凝状态，１例原因未明确。     

急性肠系膜静脉血栓形成保守治疗临床分析

目的探索急性肠系膜静脉血栓形成保守治疗指征及有效规范治疗方案。方法对本院近2年多来收治的13例急性肠系膜静脉血栓形成患者中的12例采用保守治疗,总结临床资料及有效的保守治疗方案。结果 12例急性肠系膜静脉血栓形成患者中11例采用保守治疗成功,成功率91.7%。结论如能在肠系膜静脉血栓形成患者出现肠坏死前确诊,并施以早期抗凝及＂消化道休息＂为核心的治疗方案,绝大多数患者可以通过保守治疗得到治愈。     

急性肠系膜静脉血栓11例

肠系膜静脉血栓(mesenteric venous thrombosis,MVT)是一种罕见的肠道缺血性疾病,急性MVT是出现症状4周之内.由于该病缺乏特异的临床症状和体征,发病早期难以确定诊断.今报告收治MVT患者11例.     

肠系膜静脉血栓形成三例

例 1　患者女 ,6 7岁 ,因脐周疼痛 3d ,逐渐加重入院。体检全腹压痛明显 ,右下腹肌紧张 ,血白细胞计数 (WBC)19 8× 10 9/L ,中性 0 90 ,术中见腹腔内暗红色渗液 10 0 0ml,距屈氏韧带 80cm以下至距回盲部 30cm小肠瘀血性坏死。例 2　患者男 ,5 7岁 ,因中上腹痛 2周 ,加剧 4d入院。体检上腹压痛伴肌紧张 ,腹腔穿刺出血性液体 ,WBC 13 5×10 9/L ,中性 0 88,CT示小肠血运性绞窄性梗阻。术中发现距屈氏韧带 5 0cm以下约 15 0cm左右小肠瘀血性坏死。例 3　患者女 ,5 6岁 ,因上腹痛 15d伴高热入院。体检剑突下压痛明显伴紧张 ,右下腹压痛 ,…     

门静脉高压症断流术后肠系膜静脉血栓形成1例

病人男性，55岁。因持续性脐周痛1d，伴呕血5h、昏迷4h入院。10年前因肝硬化、门静脉高压症于外院行脾切除＋贲门周围血管离断术，5年前因呕血行胃镜下曲张静脉套扎术。     

急性肠系膜上静脉血栓形成的诊断与治疗

目的 加深对急性肠系膜上静脉血栓形成(AMVT)导致急腹症严重性的认识,探讨提高疗效的措施。方法 对13例AMVT临床特点、治疗方法和效果进行分析比较。结果 入院均诊断为急腹症,但术前能确诊仅2例,拟诊1例,行小肠部分切除11例,其中小肠广泛切除3例,仅作剖腹探查2例。治愈10例,死亡3例。随诊3个月～14年,无复发,无短肠综合征发生。结论 AMVT临床表现无特异性,术前确诊困难。腹痛与腹部体征不符、WBC大于20×10~9/L时应警惕本病。彩色多普勒对诊断有较大帮助。充分认识此病,争取早期诊断及时手术是提高疗效关键,术后抗凝溶栓可防止复发。     

Clinical picture, diagnosis and surgical treatment of mesenteric vein thrombosis

Thrombosis of mesenterial veins was found to develop in 30 women and 28 men of the average age of 51 +/- 2.1 years. It was established that case history of ischemic heart disease, diseases of the liver, spleen, thrombotic lesions of vessels of different localization and splenectomy should be taken for conditions predisposing to the development of mesenterial vein thrombosis. Treatment of occlusive lesions of mesenterial veins must include not only resection of the infarction portions of the intestine, but also correction of protein-electrolytic disorders, nitrogenous and carbohydrate metabolism as well as liver function.     

腹腔镜早期诊治急性肠系膜静脉血栓的价值

目的 :探讨腹腔镜对急性肠系膜静脉血栓 (MVT)的早期诊治价值。方法 :分析在诊断性腹腔镜检查中获得早期诊治MVT 5例的临床资料 ,判断价值。结果 :5例MVT全部确诊并获得及时治疗。结论 :诊断性腹腔镜检查可以提高MVT早期确诊率 ,避免和减少肠管的坏死和切除     

急性肠系膜静脉血栓形成的诊治

目的 探讨急性肠系膜静脉血栓形成（ＡＭＶＴ）的诊断与治疗方法。方法 对１９８３年１月至１９９８年１１月间收治的１５例ＡＭＶＴ的临床资料进行回顾性分析。结果 男７例,女８例;平均年龄４２岁。发病至入院时间平均８４ｈ,手术前诊断６例,９例根据手术所见作出诊断。２例保守治疗,１３例手术治疗。平均切除肠管３００ｃｍ,４例行局部溶栓治疗。住院死亡４例,２例遗留短肠综合征。结论 早期诊断、早期抗凝的及时恰当的     

急性肠系膜静脉血栓形成的诊断治疗

1895年．Elliot最先报道了肠系膜静脉血栓可通过影响肠道静脉回流而导致肠坏死。随后于1935年Warren等正式将肠系膜静脉血栓形成mesenteric venous thrombosis,MVa3作为一个独立的肠坏死致病因素提出来,以便与系膜动脉阻塞引起的肠坏死相区别。MVT所致的肠道缺血约占整个肠系膜血管性疾病的5％．15％,通常MVT主要累及肠系膜上静脉．而肠系膜下静脉发生血栓较少,由于MVT临床表现隐匿．往往缺乏特异性症状和体征,早期诊断较困难,     

肠系膜上静脉血栓形成的诊断和治疗

目的 探讨肠系膜上静脉血栓形成的诊断及治疗。方法 总结１２例ＭＶＴ的诊治经验,从病因,诊断和治疗等方面进行分析。结果：１２例均经手术病理证实,初诊多数表现为急腹症,症状和体征不相符,９例误诊,３例术前确诊,全部行手术治疗,８例治傅,４例死亡。结论该病少见,症状和体征无特异性,难以做出准确的诊断,Ｂ超和ＣＴ是较敏感的检查,对诊断有积极的作用。     

Superior mesenteric vein thrombosis

Superior mesenteric venous occlusion may be difficult to recognize, but is important as it carries a better prognosis than superior mesenteric arterial occlusion, and may be amenable to surgical treatment. Three successful cases treated by thrombectomy have appeared in the literature. A case of successful superior mesenteric vein thrombectomy with bowel resection is reported.     

Prognostic factors and treatment outcome in mesenteric vein thrombosis

BACKGROUND: Mesenteric vein thrombosis (MVT) can result in intestinal ischemia and is associated with high morbidity and mortality due in part to its frequent delay in diagnosis. The purpose of this study was to evaluate clinical presentation, diagnostic evaluation, and treatment outcome of MVT. METHODS: Hospital records and clinical data of all patients treated for MVT were reviewed during a recent 14-year period. Clinical outcome and factors affecting survival were analyzed. RESULTS: A total of 68 patients were included in the study. Abdominal exploration was performed in 23 patients (34%), and second-look operation was necessary in 18 patients (26%). Three patients (4%) underwent unsuccessful operative mesenteric vein thrombectomy, whereas percutaneous transhepatic mesenteric thrombectomy was performed successfully in 3 patients (4%). The 30-day mortality rate was 20%. Forty-six of the 54 survivors were treated with long-term oral anticoagulation therapy. Actuarial survival at 2, 4, 6, and 10 years was 68%, 57%, 43%, and 22%, respectively. Risk factor analysis showed malignancy (P < .002), age >60 years (P < .005), cirrhosis (P < .02), symptom duration (P < .005), and bowel resection (P < .03) were associated with mortality. Logistic regression analysis showed age >60 years (odds ratio [OR], 3.64; P = .03), malignancy (OR, 3.88; P = .02), and prolonged symptom duration (OR, 5.62; P = .01) were independent predictors of mortality. CONCLUSIONS: MVT is associated with significant mortality. Prompt diagnostic evaluation with computed tomography may reduce potential treatment delay. Underlying malignancy, advanced age, and prolonged symptom duration are predictive of poor outcome.     

肠系膜静脉血栓形成的早期诊治

作者报告了１９６７年－１９９５年收治的肠系膜静脉血栓形成患者１６例的治疗经验。患者初诊主诉均为腹痛,１３例有明显易患因素。１例经彩色多普勒超声诊断,行抗凝治疗后病情缓解出院,其余１５例均行手术治疗。术前仅１例仍,误诊１４例。术后死亡７例,治愈８例,作者认为该病易患因素、症状与体征不相称的特点以及彩色多普勒超声、ＣＴ、选择性血管造对早期诊断有重要意义。早期手术切除受累肠管及其系膜、及早行抗凝治疗是降     

肠系膜静脉血栓形成的早期诊治(附16例临床分析)

作者报告了１９６７年～１９９５年收治的肠系膜静脉血栓形成患者１６例的治疗经验。患者初诊主诉均为腹痛，１３例有明显易患因素。１例经彩色多普勒超声诊断，行抗凝治疗后病情缓解出院，其余１５例均行手术治疗。术前仅１例确诊，误诊１４例。术后死亡７例，治愈８例。作者认为该病易患因素、症状与体征不相称的特点以及彩色多普勒超声、ＣＴ、选择性血管造影对早期诊断有重要意义。早期手术切除受累肠管及其系膜、及早行抗凝治疗是降低本病死亡率和复发率的关键。