肠系膜静脉血栓的临床回顾性分析（附36例）

发布时间：2018-03-14 03:42

本文选题：肠系膜静脉血栓　切入点：诱发因素　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：回顾分析36例肠系膜静脉血栓(MVT)的临床资料,总结MVT的临床诊治经验,以及提高临床医师对MVT的认识。方法：收集重庆医科大学附属第一医院血管外科2006年1月—2014年12月的36例MVT临床资料,采用百分比和频率分布描述分析,分析其一般资料、诱发因素、临床特点、实验室检查及影像学表现以及治疗方法与转归。结果：本组资料MVT总死亡5例,死亡率是13.9%,其中1例保守治疗过程中并发肺栓塞和肺部感染,死于ARDS;手术后死亡3例,其中2例再次手术治疗后死于全身严重感染合并急性肾衰竭,1例入院急诊手术48h内死于MODS:1例死于介入溶栓治疗后严重颅内出血。保守治疗15例,14例治疗好转出院；15例手术治疗(入院时腹部查体弥漫性腹膜炎症；保守治疗后病情反复并恶化出现并发症),治疗好转出院12例,5例再次手术；介入治疗6例,治疗好转出院5例,2例再次手术。结论：1.MVT临床上仍有一定死亡率,其发生机制与临床经过仍需进一步的研究。2.抗凝治疗仍然是MVT的重要治疗手段,抑制胃肠液和胃肠外营养等基础支持治疗是MVT(特别是住院时间长,肠道功能恢复慢)患者的必要手段。3.手术治疗仅仅适用于MVT引起的严重并发症如肠坏死、肠穿孔和肠梗阻等。4.溶栓和手术血栓清除治疗的疗效需要进一步观察。
[Abstract]:Objective: to retrospectively analyze the clinical data of 36 cases of mesenteric venous thrombosis (MVT) and summarize the experience of clinical diagnosis and treatment of MVT. Methods: the clinical data of 36 cases of MVT from January 2006 to December 2014 in the first affiliated Hospital of Chongqing Medical University were collected and analyzed by percentage and frequency distribution descriptive analysis. Results: five cases of MVT died, the mortality rate was 13.9, and one case was complicated with pulmonary embolism and pulmonary infection during conservative treatment. Died of ARDS; 3 cases died after surgery, Among them, 2 cases died of severe systemic infection and acute renal failure after reoperation, 1 case died of MODS:1 within 48 hours of emergency operation, 15 cases of conservative treatment were cured and 14 cases were discharged from hospital after interventional thrombolytic therapy. Surgical treatment of 15 cases (abdominal examination and diffuse peritonitis at admission); After conservative treatment, complications occurred repeatedly and deteriorated, 12 cases were cured and discharged from hospital, 5 cases were re-operated, 6 cases were interventional therapy, 5 cases were cured and 2 cases were reoperated. Conclusion: 1. MVT still has certain mortality rate clinically. 2. Anticoagulant therapy is still an important treatment method for MVT, and basic support therapy such as inhibition of gastrointestinal fluid and parenteral nutrition is MVT (especially long hospital stay). Surgical treatment is only suitable for severe complications caused by MVT, such as intestinal necrosis, intestinal perforation and intestinal obstruction. The efficacy of thrombolytic therapy and surgical thrombus removal needs further observation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.2

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