急性门静脉系统血栓形成的诊治

Diagnosis and treatment of acute portal vein thrombosis

目的探讨急性门静脉系统血栓形成的诊断方法及治疗措施。方法回顾性分析13例急性门静脉系统血栓形成病例的临床资料。结果本组13例急性门静脉系统血栓形成患者均由增强CT或MRI／MRA检查确诊。其中5例患者接受以抗凝和溶栓为主的非手术治疗，2例死亡；8例接受手术治疗（经肠系膜上静脉切开取栓及置管抗凝和溶栓），其中5例术中发现有部分小肠坏死，同时切除坏死肠段，均痊愈出院。结论外科手术治疗急性门静脉系统血栓形成疗效确切，并发症少。

Objective To discuss the diagnostic methods and therapeutical measures on acute portal vein thrombosis. Method Clinical data of 13 cases of acute portal vein thrombosis were retrospectively analyzed and its diagnosis and therapy were evaluated. Results In this group, 8 cases were male and 5 were female. The average age was （54 ± 26） years old and 6 of which had identified inducement. Diagnosis was made with enhanced CT or MRI/MRA in all cases. Among which 5 cases were treated with non-surgical method （anticoagulation and thrombolysis ） and 2 died. The other 8 cases were cured with surgical procedures （thrombectomy and tube insertion for anticoagulation and thrombolysis though superior mesenteric vein）. Segmental small intestinal necrosis necessitated small bowel resection in 5 cases. Conclusion Surgical procedures remain the important therapy of choice for acute portal vein thrombosis especially when bowel necrosis is suspected.