急性肠系膜静脉血栓形成16例临床分析

目的　分析急性肠系膜静脉血栓形成 (ASMVT)的临床特征和诊断方法。方法　对北京友谊医院 1985年 10月至 2 0 0 2年 10月确诊的 16例ASMVT的临床资料进行分析 ,并结合文献 ,总结ASMVT的临床特征和诊断方法。结果 16例ASMVT患者 ,年龄 19～ 6 4岁 (平均 4 5 9岁 )。主要症状有腹痛 ( 16 / 16 )、腹胀 ( 16 / 16 )、呕吐 ( 10 / 16 )、发热 ( 8/ 16 ) ,主要体征有腹部膨隆 ( 16 / 16 )、腹膜刺激征( 16 / 16 )。误诊率 75 % ( 12 / 16 ) ,死亡率 4 4 % ( 7/ 16 )。结论　ASMVT的临床表现有一定的特征 ,早期彩色超声检查、诊断性腹腔穿刺、结合CT或肠系膜上动脉造影异常发现可对ASMVT做出正确的诊断 ,早期手术可以降低死亡率

Clinical analysis for 16 cases of acute mesenteric venous thrombosis

Objective To analyze clinical characteristics of acute mesenteric venous thrombosis (AMVT) and its diagnositic methods. Methods Medical records of 16 patients diagnosed as SMVT in Friendship Hospital of Beijing during October 1985 to October 2002 were collected and analyzed, and its clinical characteristics and diagnostic methods were summarized.Results Median age of the 16 patients was 45.9 years, ranged from 19 to 64 years. Their main symptoms at admission were abdominal pain (100%), abdominal distension (100%), acute abdomen (100%), vomiting (75%, 12/16) and fever (75%, 12/16), with an underdiagnosis rate of 75% (12/16) and case-fatality ratio of 44% (7/16).Conclusions AMVT had several specific manifestations. Early clinical diagnosis for AMVT could be established on the basis of abdominal color doppler ultrasonography, diagnostic abdominocentesis, CT and selective superior mesenteric arteriography, and its case-fatality could be lowered with early surgical operation.