急性肠系膜静脉血栓形成的术式探讨  

Study of surgical style of treating acute mesenteric venous thrombosis.

作　　者：虞冠锋[1] 姚建高[1] 程骏[1] 郑晓风[1] 陈笑雷[1] 施红旗[1] 洪允锋[1] 王玉明[1] 张启瑜[1] 

机构地区：[1]温州医学院附属第一医院普外科,325000

出　　处：《中国实用外科杂志》2001年第3期154-155,共2页Chinese Journal of Practical Surgery

摘　　要：目的　探讨针对急性肠系膜静脉血栓形成不同程度肠缺血病变的最佳手术治疗方式。方法　 6例急腹症经影像学检查术前诊断为急性肠系膜静脉血栓形成。所有病人手术探查 ,依肠管不同缺血程度 ,对淤血性病变和坏死性病变各 3例 ,分别实行肠系膜血栓切除术和肠切除术。围手术期抗凝治疗。结果　 3例肠切除者治愈 ;3例肠系膜静脉血栓切除者 2例治愈 ,1例结肠受累者因结肠动力性肠梗阻、穿孔而再作右半结肠切除术治愈。随访 8个月至 6年无复发。结论　以血栓切除术和肠切除手术分别治疗急性肠系膜静脉血栓形成所致的肠淤血和肠坏死 ,并辅以抗凝治疗是提高生存率。Objective To explore the best therapeutic methods for acute mesenteric venous thromboses(AMVT)with different degrees of intestinal ischemic lesions.Methods 6 cases of acute abdomen were preoperatively diagnosed as AMVT with imaging.After laparotomy,patients were classified as congestive lesion(n=3)and necrotic lesion(n=3)according to the degree of intestinal sichemia and were treated with mesenteric thrombectomy and bowel resection,respectively.All cases received heparin and urokinase perioperatively.Results Of the 3 patients receiving mesenteric thrombectomy,2 were cured and the other one with ischemic ascending colon was cured after right hemicolectomy due to the complication of colic dynamic ileus and perforation 10 days after thrombectomy.The other 3 patients recovered after bowel resection.Follow up from 8 months to 6 years showed no recurrence.Conclusion Combined with anti coagulation therapy,thrombectomy and bowel resection are rational and effective protocol for congestive lesion and necrotic lesion,respectively in AMVT patients.

关 键 词：肠系膜静脉 血栓形成 血栓切除术 肠切除术 术式 

分 类 号：R657.2[医药卫生—外科学] R544.4[医药卫生—临床医学]