肠系膜静脉血栓形成8例诊治

The diagnosis and treatment of 8 cases of mesenteric vein thrombosis

目的探讨肠系膜静脉血栓形成的诊断和治疗。方法回顾性分析8例肠系膜上静脉血栓形成患者的临床资料。结果8例中4例为腹部手术后患者,4例为不明原因起病。临床主要表现为腹痛、腹胀,初期症状重但体征轻。术前确诊2例。所有患者均经手术和病理证实,全部经手术治愈,2例术后出现短肠综合征。结论肠系膜静脉血栓形成术前确诊困难。CT、彩色多普勒超声检查是诊断本病较为敏感的方法。早期手术切除受累肠管及系膜、门静脉主干出现血栓时行门静脉取栓及恰当的抗凝治疗是本病治疗的关键。

Objective To study the diagnosis and treatment of mesenteric vein thrombosis. Methods The clinical data of 8 patients with mesenteric vein thrombosis were analyzed retrospectively. Results Of 8 cases, 4 cases underwent the abdominal operations before, and the others occurred with no causes. The clinical manifestations were abdominal pain and distension. All 8 cases were confirmed by operation and pathology. 8 patients were cured, 2 of which showed postoperative short bowel syndrome. Conclusion The diagnosis of mesenteric vein thrombosis is difficult in the early stage. CT scan and color Doppler ultrasonic examination are sensitive to diagnose. Resecting the related intestine and mesentery, removing the thrombosis in the main trunk of the portal vein, and the proper management with anticoagulants are very important.