摘要
目的 探讨肝硬化上消化道出血患者常规应用止血及抗纤溶药物的利弊.方法 回顾分析我院2008年1月-2010年12月收治的肝硬化并肠系膜上静脉血栓形成3例的临床资料.结果 3例均因呕血、便血入院,均有乙型病毒性肝炎肝硬化病史,诊断为肝硬化上消化道出血后予止血、抗纤溶等治疗1～2周,出现发热、腹胀、腹痛,B超检查提示门静脉主干血栓伴肠系膜上静脉血栓形成.例1、例2予尿激酶溶栓,例3行经颈静脉肝内门体分流术治疗,均痊愈出院.结论 肝硬化上消化道大出血并急性肠系膜上静脉血栓临床较为少见,分析发生原因可能与过度应用止血及抗纤溶药物有关.
Objective To explore the advantages and disadvantages of anti-fibrinolytic agents in routine treatment of patients with upper gastrointestinal hemorrhage in liver cirrhosis.Methods Clinical data of 3 patients with liver cirrhosis complicated with superior mesenteric venous thrombosis in our hospital during January 2008 and December 2011 was retrospectively analyzed.Results Three patients were admitted for haematemesis and hematochezia with a history of viral hepatitis type B.All the patients were diagnosed as having liver cirrhosis and upper gastrointestinal bleeding,and the patients complained of fever,abdominal pain and distension after 1-2 weeks of hemostasis and anti-fibrinolysis treatment.Ultrasound scan showed main portal vein thrombosis complicated with superior mesenteric vein thrombosis.Two patients received intravenous urokinase,and the other one was treated with transjugular intrahepatic portosystemic shunt.All the three patients were cured and discharged.Conclusion The massive hemorrhage of the upper alimentary tract of liver cirrhosis complicated with acute superior mesenteric venous thrombosis is extremely rare in clinically,and its pathogenesis may be related with overuse of hemostatics and anti-fibrinolytic agents.
出处
《临床误诊误治》
2013年第12期6-9,共4页
Clinical Misdiagnosis & Mistherapy
基金
陕西省科技计划项目(2010K15-03-06)
国家自然科学基金项目(30571658)
关键词
肝硬化
上消化道出血
肠系膜上静脉血栓形成
抗纤溶药
误诊
Liver cirrhosis
Upper gastrointestinal hemorrhage
Superior mesenteric venous thrombosis
Antifibrinolytic agent
Misdiagnosis
