急性肠系膜上静脉血栓形成的诊治体会(附14例报告)

Diagnosis and treatment of acute mesenteric vein thrombosis:A clinical report of 14 cases

目的探讨急性肠系膜上静脉血栓形成（MVT）的诊疗方法。方法回顾性分析我们2000年1月-2005年12月收治的14例MVT的临床资料。本组行肠切除及Fogarty导管取栓术8例，行抗凝、溶栓治疗6例。结果本组治愈13例，死亡1例。结论超声、CT和MRV诊断价值较大。及早诊断，行抗凝、溶栓治疗可防止肠坏死的发生。对出现肠坏死、腹膜炎者，切除坏死肠管及系膜，同时积极抗凝治疗能降低死亡率和复发率。尿激酶联合巴曲酶治疗MVT是有效和安全的。

Objective To study the clinical characteristics and therapy of acute mesenteric venous thrombosis（MVT）. Methods The diagnosis and treatment were reviewed respectively in 14 patients with MVT. Results Eight cases were subjected to intestinal resection and Fogarty embolectomy. Six cases were cured by thrombolysis. Thirteen patients were cured,and 1 died. Conclusion Ultrasonography,CT and MRV are useful in the diagnosis of MVT. Early diagnosis and active thrombolysis may help to prevent the intestinal necrosis. Intestinal resection with its mesentery and Fogarty embolectomy in the mesenteric vein or in the portal vein should be performed for the patients who suffered from intestinal necrosis as soon as possible. Active anticoagulation should be performed simultaneously,which is essential to decrease the mortality and to prevent the recurrence. Thrombolytic therapy of acute MVT with Urokinase and Bat roxobin is feasible,effective and safe.