机械吸栓联合肠系膜上动脉置管溶栓治疗门静脉血栓形成的研究  

Mechanical thrombus aspiration combined with superior mesenteric artery transcatheter thrombolysis in the treatment of portal vein thrombosis

作　　者：刘彬[1] 冯海[1] 陈学明[1] 李文睿 于宏志[1] Liu Bin;Feng Hai;Chen Xueming;Li Wenrui;Yu Hongzhi(Department of Vascular Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院血管外科,北京100050

出　　处：《国际外科学杂志》2023年第3期155-159,F0003,共6页International Journal of Surgery

摘　　要：目的:比较机械吸栓联合肠系膜上动脉置管溶栓与单纯肠系膜上动脉置管溶栓治疗门静脉血栓形成(PVT)的有效性和安全性。方法:采用回顾性病例对照研究的方法分析2020年2月—2022年10月首都医科大学附属北京友谊医院收治的27例行介入治疗的PVT患者的临床资料。根据介入术式不同分为两组,其中13例接受机械吸栓联合肠系膜上动脉置管溶栓治疗(联合治疗组),14例接受单纯肠系膜上动脉置管溶栓治疗(置管溶栓组)。观察比较两种治疗方法术后及术前门静脉血栓分级、置管溶栓时间、肠外营养时间及手术相关并发症,术后随访比较远期肠切除发生率。正态分布的计量资料以均数±标准差(x±s)表示,组间比较采用t检验;计数资料以例数和百分比(%)表示,组间比较采用χ^(2)检验或Fisher确切概率法。结果:联合治疗组与置管溶栓组术后门静脉血栓分级差异有统计学意义(P<0.05)。联合治疗组与置管溶栓组置管溶栓时间分别为(2.38±0.74)d、(4.79±1.15)d,肠外营养时间分别为(4.08±2.87)d、(8.50±3.16)d,两组相比差异均有统计学意义(P<0.05)。两组手术相关并发症差异无统计学意义(P>0.05)。两组患者均未出现严重肝肾功能损伤。两组各有1例患者远期行肠切除术。结论:机械吸栓联合肠系膜上动脉置管溶栓治疗PVT安全有效,与单纯肠系膜上动脉置管溶栓相比可提高血栓清除率、降低置管溶栓及肠外营养支持时间。Objective:To compare the effectiveness and safety of mechanical thrombus aspiration combined with superior mesenteric artery transcatheter thrombolysis with those of simple superior mesenteric artery transcatheter thrombolysis in the treatment of portal vein-superior mesenteric vein thrombosis.Methods:A retrospective case-control study was used to analyze the clinical data of 27 patients with portal vein thrombosis treated by interventional therapy in Beijing Friendship Hospital Affiliated to Capital Medical University from February 2020 to October 2022.According to different interventional procedures,they were divided into two groups:13 cases were treated with mechanical thrombus aspiration combined with superior mesenteric artery catheterization thrombolysis(combined treatment group),and 14 cases were treated with superior mesenteric artery catheterization thrombolysis alone(catheterization thrombolysis group).The postoperative and preoperative portal vein thrombus grade,catheterization thrombolysis time,parenteral nutrition time and operation-related complications were observed and compared between the two methods,and the incidence of long-term intestinal necrosis was compared after postoperative follow-up.Measurement data of normal distribution were expressed as mean±standard deviation(x±s),t-test was used for comparison between groups.Counting data were expressed as cases and percentage(%),and comparison between groups was used Chi-square test or Fisher exact probability method.Results:There was significant difference in the grade of portal vein thrombosis between the combined treatment group and the catheterization thrombolysis group(P<0.05).The thrombolytic time of catheterization in the two groups was(2.38±0.74)d and(4.79±1.15)d,respectively,and the time of parenteral nutrition was(4.08±2.87)d and(8.50±3.16)d,respectively.The difference was statistically significant(P<0.05).There was no significant difference in operation-related complications between the two groups(P>0.05).There were no severe inju

关 键 词：肠系膜上动脉 静脉血栓栓塞 门静脉血栓形成 机械吸栓 置管溶栓 

分 类 号：R543.6[医药卫生—心血管疾病]