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目的探讨经皮肝穿门静脉置管溶栓治疗急性肠系膜上静脉血栓的效果。方法回顾性分析我院2005年8月至2009年4月期间通过经皮肝穿门静脉置管溶栓对7例急性肠系膜上静脉血栓患者的治疗情况及疗效。结果 7例经皮肝穿门静脉置管均成功,穿刺后无漏胆,无腹腔出血。患者腹痛、腹胀和血便症状在2～5d内缓解,2～5d开始进食流质。1例患者因症状加重而行急诊手术,无肠瘘发生。复查造影显示大部分或全部血栓被清除,门静脉和肠系膜上静脉血流通畅。随访3个月至3年,均无复发。结论经皮肝穿门静脉置管溶栓治疗急性肠系膜上静脉血栓是安全、有效的。
Objective To investigate the effect of percutaneous transhepatic portal vein thrombolysis on acute superior mesenteric venous thrombosis. Methods The clinical data of 7 patients with acute superior mesenteric vein thrombosis treated with percutaneous transhepatic portal vein thrombolysis in our hospital from August 2005 to April 2009 were retrospectively analyzed. Results 7 cases of percutaneous transhepatic portal vein catheterization were successful, no puncture after gallbladder, no intra-abdominal bleeding. Patients with abdominal pain, bloating and bloody stool symptoms in 2 ~ 5d ease, 2 ~ 5d began to eat liquid. One patient underwent emergency surgery due to the worsening of symptoms, no intestinal fistula occurred. A review of the angiography showed that most or all of the thrombi were cleared, and portal and superior mesenteric veins were unobstructed. Follow-up 3 months to 3 years, no recurrence. Conclusion Percutaneous transhepatic portal vein thrombolysis for the treatment of acute superior mesenteric vein thrombosis is safe and effective.