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肠系膜静脉血栓形成和肠系膜静脉硬化症的临床分析

The clinical analysis of mesenteric venous thrombosis and mesenteric Phlebosclerosis

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【作者】 王平; 石春伟; 刘文娟; 朱雅琪;

【Author】 Wang Ping; Shi Chunwei; Liu Winjuan; et al(Department of Aging Medicine of Heilongjiang Provencial Hospital, Harbin 150036)

【机构】 黑龙江省医院老年病科!哈尔滨150036;

【摘要】 本文报告了肠系膜静脉血栓形成(MVT)7例和肠系膜静脉硬化症(MPS)2例,就其临床表现,X线和肉眼病理所见加以叙述。方法回例做肠系膜动脉造影(SMA),5例反复做X线腹部平片检查,全例最后诊断依剖腹术。结果SMA疑MVT1例,X线显示5例肠梗阻,仅2例见扩张的小肠见有肥厚的肠壁襟,外科和病理证实肠梗死是由于血栓形成。来自于肠系膜上静脉和主要分支有7例,而2例是由MPS所致,受累的肠管已坏死并肠壁水肿和出血,又肠系膜水肿和增厚,能手术的4例(住院后36小时内),3例成活(2例为MPS),从住院到剖腹术延误时间中位数为2.5天,6例死亡(包括1例术后吻合口再栓塞),死亡率66.7%。结论MVT和MPS其临床特征是剧烈腹痛,症状大于体征,早期诊断并对可疑之病人立即剖腹术是最重要的。

【Abstract】 Aim This papar reported with mesenteric venous thrombisis(MVT) in 7 patients and mesenteric Phlebosclerosis (MPS) in 2 patients, the clinical features, radiological changes and macropathologic findings were described.Method one case with superior mesenteric arteriography (SMA) and 5 cases with repeated plain abdominal X - Hay were examinated, all ceases were ultinately diagnosed by laparotomy. Results MVT was suspected with Sin in one case, the X - rayshowed lieus in 5 cases, but cop 2 cases demonstrating dilation of the small intestine with thick - walled hop. The surgical orpathological findings of intestinal infarction due to thrombosis from superior mesenteric vein and its major branches in 7 cases,but 2 cases were attribute to MPS, the involved bowel was gangrenous, with edernatous and hemorrhopc wall, as well as edematous with thickening of mesentery. The operable patients had 4 cases (within 36h aller adimison), 3 cases survived (PMS in 2Cases), the median time delay was 2. 5 days from adlnision to laparotomy. Six cases died (included one case with reccurentthrolnbosis 4t the site of anastomosis), the mora tlity rate was 66. 7%. ConcluSions The charateristical clinical feattire ofMVT or MPS is severe abdominal pain, the apperance of Pain is more than sugrsted by physical finding. Early diagnosis andifnlnediated laparotomy is the most important treaIJnent for suspected patients.

  • 【文献出处】 胃肠病学和肝病学杂志 ,CHINESE JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY , 编辑部邮箱 ,1999年01期
  • 【分类号】R657.2
  • 【被引频次】2
  • 【下载频次】52
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