肠系膜静脉血栓形成和肠系膜静脉硬化症的临床分析

The clinical analysis of mesenteric venous thrombosis and mesenteric Phlebosclerosis

本文报告了肠系膜静脉血栓形成（ＭＶＴ）７例和肠系膜静脉硬化症（ＭＰＳ）２例，就其临床表现，Ｘ线和肉眼病理所见加以叙述。方法回例做肠系膜动脉造影（ＳＭＡ），５例反复做Ｘ线腹部平片检查，全例最后诊断依剖腹术。结果ＳＭＡ疑ＭＶＴ１例，Ｘ线显示５例肠梗阻，仅２例见扩张的小肠见有肥厚的肠壁襟，外科和病理证实肠梗死是由于血栓形成。来自于肠系膜上静脉和主要分支有７例，而２例是由ＭＰＳ所致，受累的肠管已坏死并肠壁水肿和出血，又肠系膜水肿和增厚，能手术的４例（住院后３６小时内），３例成活（２例为ＭＰＳ），从住院到剖腹术延误时间中位数为２．５天，６例死亡（包括１例术后吻合口再栓塞），死亡率６６．７％。结论ＭＶＴ和ＭＰＳ其临床特征是剧烈腹痛，症状大于体征，早期诊断并对可疑之病人立即剖腹术是最重要的。

Aim This papar reported with mesenteric venous thrombisis(MVT) in 7 patients and mesenteric Phlebosclerosis (MPS) in 2 patients, the clinical features, radiological changes and macropathologic findings were described.Method one case with superior mesenteric arteriography (SMA) and 5 cases with repeated plain abdominal X - Hay were examinated, all ceases were ultinately diagnosed by laparotomy. Results MVT was suspected with Sin in one case, the X - rayshowed lieus in 5 cases, but cop 2 cases demonstrating dilation of the small intestine with thick - walled hop. The surgical orpathological findings of intestinal infarction due to thrombosis from superior mesenteric vein and its major branches in 7 cases,but 2 cases were attribute to MPS, the involved bowel was gangrenous, with edernatous and hemorrhopc wall, as well as edematous with thickening of mesentery. The operable patients had 4 cases (within 36h aller adimison), 3 cases survived (PMS in 2Cases), the median time delay was 2. 5 days from adlnision to laparotomy. Six cases died (included one case with reccurentthrolnbosis 4t the site of anastomosis), the mora tlity rate was 66. 7%. ConcluSions The charateristical clinical feattire ofMVT or MPS is severe abdominal pain, the apperance of Pain is more than sugrsted by physical finding. Early diagnosis andifnlnediated laparotomy is the most important treaIJnent for suspected patients.