肠系膜上静脉血栓形成的诊断和治疗

The diagnosis and treatment of superior mesenteric venous thrombosis

目的探讨肠系膜上静脉血栓形成（MVT）的诊断及治疗。方法总结12例MVT的诊治经验，从病因、诊断和治疗等方面进行分析。结果12例均经手术病理证实，初诊多数表现为患腹症，症状和体征不相符，9例误诊，3例术前确诊，全部行手术治疗，8例治愈，4例死亡。结论该病少见，症状和体征无特异性，难以做出准确的诊断，B超和CT是较敏感的检查，对诊断有积极的作用。早期切除坏死肠段，包括静脉阻塞的肠系膜部分，水中和术后抗凝治疗是防止复发、降低病死率的重要措施。

Objective To study the diagnosis and treatment of MVT. Methods The etiology, diagnosis and treatment of 12 patients with mesenteric venous thrombosis(MVT) which had been treated in our hospital since 1980 wereanalyzed. Results The patients were all operated on and the diagnosis was confirmed pathologically. The most patientssuffered the acute abdominal pain and sign were in the discordance. 8 patients cured, 4 died. Couclusion (1 )MVT is anuncommon disease, its symptoms and signs nonspecific, should not be relied on for accurate diagnosis. Ultrasonography,CT were the sensitive diagnosis; (2 ) and early operating for the resecting bowl gangrene involving its mesentery, early application of anticoagulant therapy are essential to reduce the mortality and recurrence.