急性肠系膜静脉血栓形成的非手术治疗

Nonoperative clinical mangement for acute mesenteric venous thrombosis

目的 探讨非手术治疗急性MVT的优势以及治疗该病的最佳方案。方法 回顾 1995～ 2 0 0 2年间收治的 17例经非手术治疗的急性肠系膜静脉血栓形成 (mesentericvenousthrombosis,MVT)的诊断、治疗及预后 ,对急性MVT诊断一经确立后 ,立即采用抗凝溶栓等保守治疗 ,并严密观察 ,如有急性腹膜炎发生则随时中转手术。结果 病人全部治愈 ,治疗过程中无中转手术发生。平均住院天数为 ( 11 9± 3 7)天。2年生存率为 88 2 %。结论 早期诊断及抗凝溶栓治疗直接影响到该病的预后 ;在肠缺血尚未导致透壁性肠坏死、肠穿孔时 ,非手术治疗完全可行。

Objective To review the results obtained from nonoperative management for acute mesenteric venous thrombosis (MVT) and determine the best initial management for this disease. Methods Patients treated for acute MVT in our hospital from January 1995 to November 2002 were retrospectively analyzed.Our departmental policy was to perform nonoperative approach at admission once diagnosis was established.Patients were then under intensive care and underwent secondary operation when indicated.Results Seventeen patients received nonoperative treatment.All recovered. No secondary operation indicated. Mean duration of hospitalization was (11.9±3.7) days.Two-year survival rate was 88.2%.Conclusion Early diagnosis,early anti-coagulation and thrombolytic therapy are beneficial to the patients and directly influence progression of the disease.Nonoperative management for acute MVT is feasible when the initial diagnosis is certain and bowel infarction has not led to transmural necrosis and bowel perforation.