介入联合手术治疗门静脉血栓形成7例

Interventional combined with surgical therapy of 7 cases of portal venous thrombosis

目的评价介入联合手术治疗门静脉血栓形成的疗效。方法对7例术前确诊为门静脉血栓形成者行开腹经肠系膜上静脉的门静脉内手术取栓、局部溶栓和门静脉狭窄/闭塞段球囊扩张、内支架置入术。2例因小肠坏死、1例因肠腔明显狭窄而同时行部分小肠切除术。结果7例均治疗成功。术前腹痛、腹胀及消化道症状消失,腹水基本消失。随访3～24个月,平均16个月,均健在,无消化道出血。多普勒超声复查显示门静脉血流通畅。结论介入联合手术是治疗门静脉血栓形成的安全、有效方法。

Objective To assess the efficacy and safety of interventional combine with surgical therapy of symptomatic portal vein thrombosis （PVT）. Methods Seven patients with PVT were treated by surgical thrombectomy, regional medical thrombolysis, and angioplasty or stenting. Resection of part of the small intestine was performed in 2 cases due to enteric necrosis and in 1 case because of enteric stenosis. Results The procedure was successful in all the 7 patients. The preoperative symptoms （ abdominal pain, distention, and ascites） were alleviated apparently. Follow-up observations for 3 -24 months （mean, 16 months） showed no death. No alimentary tract hemorrhage occurred. Re-examinations with Doppler ultrasonography revealed patent blood flow in the portal vein. Conclusions Interventional combined with surgical therapy is safe and effective in the treatment of symptomatic portal venous thrombosis.