摘要
目的 总结急性肠系膜上静脉血栓形成 (superiormesentericvenousthrombosis ,SMVT)诊治经验。方法 回顾性研究了 1 978年 1月至 2 0 0 3年 8月收治的 4 1例急性SMVT患者的临床资料 ,将其分为两组 ,1 995年以前为Ⅰ组 (1 3例 ) ,诊治原则是对可疑的急性SMVT的患者施行手术探查 ;1 995年及 1 995年以后为Ⅱ组 (2 8例 ) ,改变为一经确诊后立即采用抗凝、溶栓治疗 ,并严密观察 ,如有急性腹膜炎发生则随时中转手术。本研究对两组的诊治过程、住院时间、死亡率及生存率等因素的差异进行了分析比较。结果 两组比较 ,入院后确诊时间 ,Ⅰ组平均为 (7 . 3± 2 . 6 )d ;Ⅱ组平均为 (1 . 5± 1 . 2 )d ,P <0 . 0 1。手术治疗者Ⅰ组 1 1例 ,Ⅱ组 9例。治愈率Ⅰ组为 6 1 . 5 %,Ⅱ组为 89 .3%,P <0 . 0 5。结论 早期诊断、早期抗凝溶栓治疗等非手术治疗可以提高急性SMVT的治愈率。
Objective To sum up our experience in the diagnosis and management of acute superior mesenteric venous thrombosis (SMVT). Methods We retrospectively reviewed 41 patients treated for acute SMVT admitted in our hospital from Jan 1978 to Aug 2003. Before 1995 (group Ⅰ), a surgery was preformed in patients with suspected acute SMVT. Since Jan 1995 (Group Ⅱ), aggressive medical therapy was immediately delivered, and the patients were subjected to laparatomy with suspected peritonity. Results There were 13 cases in group Ⅰ, and 28 in group Ⅱ. Mortality in group Ⅰ was 38.5%, and that in group Ⅱ was 10.7% (P<0.05). The time for the establishment of diagnosis was (7.3±2.6)d, in group Ⅰ and (1.5±1.2)d in group Ⅱ, respectively (P<0.01). Eleven cases in group Ⅰ underwent a surgery, and 9 cases in group Ⅱ received a surgery, with care rate of 61.5% and 89.3%, respectively (P<0.05). Conclusion Early diagnosis, early anti-coagulative and thrombolytic therapy, and hence less patients were subjected to a surgery improve the cure rate of acute SMVT.
出处
《中华普通外科杂志》
CSCD
北大核心
2005年第1期21-23,共3页
Chinese Journal of General Surgery
