急性肠系膜静脉血栓形成的临床分析
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代远斌 E-mail:dyb630611@163.com

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Acute mesenteric venous thrombosis
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    摘要:

    目的:探讨急性肠系膜静脉血栓形成(AMVT)的早期诊断及治疗方法。
    方法:回顾性分析庆重庆医科大学附属第一医院2007年8月—2010年5月收治的25例AMVT患者的临床资料。
    结果:25例均表现有腹痛,11例出现腹膜刺激征者;25例均由腹部CTA明确诊断。13例手术治疗,5例行肠系膜上动脉插管溶栓治疗,7例经外周给予抗凝、溶栓治疗。21例治愈,4例(2例手术治疗,2例保守治疗)治疗过程中并发多器官功能衰竭,放弃治疗,随访2~24个月,2例分别于术后2,4个月复发。
    结论:彩超和CTA可早期确诊AMVT,确诊后及时适当抗凝溶栓治疗或手术治疗,术后继续抗凝溶栓治疗,可取得较好临床疗效。

    Abstract:

    Objective:To investigate the early diagnosis and treatment of acute mesenteric venous thrombosis (AMVT).
    Methods:Retrospective analysis of the clinical data of 25 patients with AMVT admitted to the First Affiliated Hospital of Chongqing Medical University from August 2008 to May 2010 was carried out.
    Results:All of the 25 patients had abdominal pain, and with signs of peritoneal irritation in 11. The 25 patients were diagnosised by CTA. Thirteen patients underwent laparotomy, 5 received regional  thrombolytic therapy via superior mesenteric artery, and 7 received anticoagulation and thrombolytic therapy by peripheral venous route. Twenty-one patients were cured, but four patients died including two who had surgical treatment and two who were treated conservatively. At follow-up of 2-24 months, there were two cases of recurrence.
    Conclusions:After diagnosis of AMVT is determined by color doppler ultrasound and CTA, prompt treatment with anticoagulation and thrombolytic medication, and in cases of peritonitis, surgery with postoperative thrombolysis and anticoagulant therapy, can resut in good clinical outcome.

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徐文豪|郭发才|代远斌.急性肠系膜静脉血栓形成的临床分析[J].中国普通外科杂志,2010,19(12):1321-1323.
DOI:10.7659/j. issn.1005-6947.2010.12.018

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  • 收稿日期:2010-06-14
  • 最后修改日期:2010-11-17
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  • 在线发布日期: 2010-12-15