摘要
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 30 0cm ,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、早期抗凝和及时恰当的手术是改善AMVT患者预后的根本措施。可能存在的高凝状态和与体征不符的腹痛是早期诊断的重要线索 ,彩色多普勒、CT是敏感的检查方法。局部溶栓可提高疗效 ,减少并发症。有计划的再剖腹是最大程度地保留有生机肠管的必要步骤。
Objective To evaluate the progress in diagnosis and management of acute mesenteric vein thrombosis (AMVT). Methods Fifteen patients with AMVT treated from January 1983 to November 1998 were reviewed retrospectively. They were 7 men and 8 women, aged on average 42 years. The duration from onset of symptoms to admission was 24-168 hours (mean 84 hours). Results Six patients were diagnosed before operation, while 9 during laparotomy.Two patients received conservative treatment and the rest underwent surgery.The average length of bowel resection was 300 cm. All the patients received anticoagulation therapy with heparin immediately after operation. Local thrombolgtic therapy was given to 4 patients. Four patients died in hospital and two had sequelae of short bowel syndrome. Conclusions AMVT is rare but a potentially lethal emergency disease. Early diagnosis, anticoagulation and appropriate surgical approach are essential to improve the prognosis. It is important to keep vigilance for AMVT in the patients in the hypercoagulation status, especially when the symptoms are inconsistent with abdominal signs. Color US and CT appear to be sensitive in the diagnosis of this condition. Local thrombolgtic therapy will be effective. Second look is a necessarily procedure for reserving the bowel that may be alive. Laparoscopy technique will play an important role in the diagnosis and treatment for AMVT.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2000年第3期173-175,共3页
Chinese Journal of Surgery
关键词
血栓形成
肠系膜静脉
诊断
治疗
AMVT
Thrombosis, Mesenteric vein
Diagnosis
Thrombus,therapeutics
