肠系膜上静脉血栓形成的治疗

The treatment of superior mensenteric venous thrombosis

目的探讨肠系膜上静脉血栓形成(SMVT)的治疗方法及疗效。方法回顾性分析20年间收治的SMVT患者35例的临床资料,按入院时间分为1990—2003年组(Ⅰ组)和2004—2009年组(Ⅱ组),Ⅰ组以手术治疗为主、部分患者术后抗凝,Ⅱ组以抗凝溶栓治疗为主,有手术指征者及时手术。对两组患者的治疗方法、住院时间、治愈率、病死率进行比较分析。结果两组患者的治疗方法构成比差异有统计学意义(P<0.01)。两组住院时间分别为(21.8±12.3)d及(11.7±6.2)d;治愈率由58.8%(I组)提高到88.9%(II组);病死率由41.2%(I组)下降到11.1%(II组)。两组住院时间、治愈率、病死率有统计学差异(P<0.05)。结论近年来SMVT的治愈率较前有明显提高。早期确诊、及时抗凝、溶栓治疗是提高预后的关键。

Objective To study the methods and outcome of treatment of superior mensenteric venous thrombosis（SMVT）.Methods The clinical data of 35 patients with SMVT during the last twenty years were studied retrospectively.They were divided into two groups according to the dmission time：the 1990—2003 group（groupⅠ） and the 2004—2009 group（groupⅡ）.Most patients in group Ⅰreceived surgical treatment,and most patients in group Ⅱreceived anticoagulation and thrombolysis therapy.Treatment modality,hospital stay days,cure rate and mortality between the groups were compared.Results The constitution ratio of treatment was significantly different between the two groups （P0.01）.The hospital stay days in two groups was （21.8±12.3）d vs.（11.7±6.2）d,the cure rate increased from 58.8% （group I） to 88.9%（group II）,and the mortality decreased from 41.2%（group I） to 11.1%（group II）.Significant difference were found in treatment,hospital stay days,cure rate and mortality between the two groups（all P0.05）.Conclusions The cure rate of SMVT has significantly increased in recent period of time.Timely diagnosis and prompt anticoagulant therapy can ensure satisfactory treatment outcomes in patients with SMVT.