急性肠系膜静脉血栓形成的诊断和治疗

Diagnosis and Treatment of Acute Mesenteric Venous Thrombosis

目的 探讨急性肠系膜静脉血栓形成的诊断及治疗。方法 回顾分析1982～2002年间收治的22例急性肠系膜静脉血栓形成病人,总结其诊断、治疗的经验。结果 22例急性肠系膜静脉血栓形成中,术前误诊14例,有9例行CT检查,8例确诊,17例行手术治疗,13例治愈,4例死亡。有5例没有腹膜炎的肠系膜、静脉血栓形成的病人行溶栓、抗凝治疗,全部治愈。结论 急性肠系膜静脉血栓形成较易误诊,CT是较敏感的检查方法,对诊断有积极的作用。坏死肠段切除要充分,应包括静脉阻塞的肠系膜部分,在没有腹膜炎的急性肠系膜静脉血栓形成病人行溶栓,抗凝治疗,是完全可行的。

Objective To study the diagnosis and treatment of acute mesenteric venous therombosis. Methods 22 cases of acute mesenteric venous thrombosis treated from 1982 to 2002 year have been analyzed and the experience of diagnosis and treatment has been summed up. Results 14 cases among 22 cases had been misdiagnosed before operation, of which 9 cases had taken CT test, 8 cases had diagnosed, 17 cases hadperformed operation, 13 cases had been cured and 4 cases died. 5 cases had completely recovered after dissolving blood embolism and resisting blood clot form. Conclusion It is easy to misdiagnosed patients with acute mesenteric thrombosis and CT test is a sensitive test method and it plays an active role in diagnosis. Nectosis parts should be removed enoughincluding venous thrombosis part. It is available for the patients without peritonitis to dissolve thrombosis resist blood clot form.