脾切除术后肠系膜上静脉血栓形成治疗体会

Treatment of Superior Mesenteric Venous Thrombosis after Splenectomy

目的探讨脾切除术后肠系膜上静脉血栓形成的诊断及治疗。方法回顾性分析2008年1月—2012年10月收治的11例脾切除术后发生肠系膜上静脉血栓患者诊治资料。均行彩色多普勒超声检查,其中8例行增强CT检查。结果保守治疗10例和手术治疗1例,均痊愈出院。随访2～25个月,3个月后复发1例,再次治疗后痊愈;6个月后复发1例,死亡。结论脾切除为肠系膜上静脉血栓形成的常见诱因,B超及增强CT检查对肠系膜上静脉血栓形成的早期诊断和鉴别诊断有重要意义,早期抗凝和溶栓是改善肠系膜上静脉血栓形成的根本措施。

Objective To explore the diagnosis and treatment of superior mesenteric venous thrombosis （SMVT） after splenectomy. Methods Clinical data of 11 patients with SMVT after spleneetomy during January 2008 and October 2012 was retrospectively analyzed. All patients accepted color doppler ultrasonography, and 8 patients of them were per- formed enhancement CT scan. Results The 10 patients were given expectant treatment, and 1 patient was treated with operation. All patients were cured and discharged from hospital. There was 1 patient with recurrence three months after discharged with 2-25 months follow-up, and the patient were cured with re-treatment; another patient recurred at six months and died. Conclusion Splenectomy is the common inducement of SMVT. Doppler ultrasonography and enhance- ment CT are very important for early diagnosis and differential diagnosis. Early anticoagulated and thrombolysis are the es- sential measures in improvement of SMVT.