【摘要】 目的:探讨急性肠系膜上静脉血栓形成的病因、临床表现及诊断治疗。方法:35例急性肠系膜上静脉血栓形成患者中26例确诊后给予抗凝溶栓治疗。9例确诊后即行手术治疗,均行小肠部分切除术,术后继续抗凝治疗。结果:抗凝溶栓组26例中22例治愈,5例出院后于两年内复发再次入院治疗,4例中转手术,1例术后死亡。急症手术组9例治愈8例,术后死亡1例。结论:急性肠系膜上静脉血栓形成与腹部手术、高凝状态及门脉高压有关。腹部强化CT检查,早期诊断并抗凝溶栓治疗,可取得较好的疗效。手术时机把握合适,术中正确判断切除坏死肠管范围及术后抗凝治疗,是降低死亡率的关键。更多还原

【Abstract】 Objective To discuss the etiology,manifestations,diagnosis and therapy of acute superior mesenteric venous thrombosis.Methods Of all thirty-five patients with acute superior mesenteric venous thrombosis,twenty-six patients were treated medically by anticoagulant and thrombolytic therapy.Nine patients under surgical management were treated by partial resection of the small intestine and after operation thrombolytic therapies were administrated.Results Twenty-two patients in anticoagulant and thrombolytic therapy group were cured.Five patients showed recurrence.Four of them needed surgical intervention and one patient died after surgery.Nine patients received emergency surgical treatment,eight of them survived while one died.Conclusion The main causes of acute superior mesenteric venous thrombosis are abdominal surgery,hypercoagulation disorders and portal hypertension.Appropriate use of abdominal enhanced CT examination,early diagnosis and anticoagulant thrombolytic therapy are crucial for better therapeutic results.An appropriate timed surgery with removal of necrotic bowel adequately and postoperative anticoagulation therapy are keys to reduce mortality.更多还原