急性肠系膜静脉血栓临床特点及预后影响因素分析  

Clinical Spectrum of Acute Mesenteric Venous Thrombosis and Factors Influencing the Prognosis

作　　者：陈建立[1] 张国志[2] 常艳[3] 张静宇[3] 胡广云[3] 戚峰[1] 刘彤[1] 

机构地区：[1]天津医科大学总医院普外科,天津市300052 [2]河北联合大学附属医院普外科,河北省唐山市 [3]河北联合大学附属医院唐海医院,河北省唐海县

出　　处：《中国全科医学》2012年第9期1043-1044,共2页Chinese General Practice

基　　金：河北省2010年医学科学研究重点课题(20100130)

摘　　要：目的探讨急性肠系膜静脉血栓的临床特征、诊断和治疗方法,研究影响患者预后的因素。方法回顾性分析河北联合大学附属医院2000—2010年20例急性肠系膜静脉血栓患者的临床资料。结果主要症状有腹痛、腹胀、发热、呕吐和血便。12例患者接受单纯抗凝治疗,8例患者接受手术治疗,4例患者30 d内死亡。发病<3 d组较发病≥3 d组手术治疗和30 d病死率明显增多,差异均有统计学意义(P<0.05);单部位血栓组较多部位血栓组手术治疗明显增多,差异有统计学意义(P<0.05)。结论本病症状不典型,CT检查对诊断有重要意义,抗凝和手术治疗是主要治疗手段,患者入院前症状持续时间对患者预后及治疗方案的选择有重大影响。Objective To analyze the clinical spectrum, diagnosis and treatment of acute mesenteric venous thrombo- sis （AMVT） and to assess the factors affecting the prognosis. Methods Clinical data of 20 AMVT patients admitted to the Affilia- ted Hospital of Hebei United University were retrospectively analyzed. Results The main symptoms were abdominal pain, ab- dominal distension, fever, vomiting and bloody stool 12 patients were treated with anticoagulation and 8 patients were treated with operation. 4 patients died in 30 days. The patients who need surgery and the mortality rate were significantly higher in the group in which disease onset 〈 3 d compared with the group in which disease onset ≥3 d （P 〈 0. 05 ） . Significantly more patients need surgery in multiple vein thrombosis group than in single vein thrombosis group （ P 〈 0. 05 ） . Conclusion The symptoms of AMVT are atypical. CT plays an important role in the diagnosis of the disease. Anticoagulation and operation are the main treat- ments. Duration of symptoms before admission to hospital can significantly affect the choosing of treatment and the prognosis.

关 键 词：肠系膜静脉 静脉血栓形成 抗凝药 外科手术 

分 类 号：R572.3[医药卫生—消化系统]