肠系膜静脉血栓31例

Diagnosis and management of mesenteric venous thrombosis:an analysis of 31 cases

目的:总结肠系膜静脉血栓形成(mesenteric venous thrombosis,MVT)的临床经验,探讨MVT形成的临床表现、诊断和治疗.方法:回顾性分析河北联合大学附属医院31例MVT住院患者的临床资料,调查其危险因素、既往血栓史、主诉和查体、实验室检查、放射学检查、治疗及预后.结果:1990-2010共收治MVT患者31例;男性24例,女性7例;平均年龄55.6岁;主要的临床表现为腹痛(100%)、呕吐(77.4%,24/31)、腹胀(64.5%,20/31)、便秘(41.9%,13/31);肝脏疾病、既往手术史、糖尿病和恶性肿瘤是MVT的主要高危因素;增强CT扫描是首选检查手段.7例患者接受单纯抗凝治疗,24例患者接受手术治疗;4例患者死亡.抗凝和手术治疗是MVT的主要治疗手段.结论:MVT临床表现无特异性;早期诊断,及时治疗是改善预后的关键.

AIM：To summarize the experience of diagnosis and management of mesenteric venous thrombosis （MVT）.METHODS：The clinical data for 31 patients with MVT treated at Tangshan Hospital from 1990 to 2010 were retrospectively analyzed.The risk factors,history of thrombosis,chief complaints,medical examination,laboratory examination,radiological examination,treatment methods,and prognosis were analyzed.RESULTS：Of 31 patients,24 were males and 7 were females.Their median age was 55.6 years.Main symptoms at presentation were abdominal pain （100%）,vomiting （77.4%,24/31）,abdominal distension （64.5%,20/31）,and constipation （41.9%,13/31）.Main risk factors were liver disease,previous operation history,diabetes and malignancies.Contrast-enhanced CT is the most sensitive means for detection of MVT.Seven patients were treated by anticoagulation and 24 patients by surgery.Four patients died.Anticoagulation therapy and surgery were main treatments.CONCLUSION：Increased awareness,earlier diagnosis and anticoagulation therapy are associated with decreased mortality rates in patients with MVT.