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目的探讨搅拌联合经导管直接溶栓治疗非肝硬化急性门静脉血栓的临床疗效。方法搜集5例非肝硬化急性门静脉血栓,经皮经肝或经颈静脉肝内穿刺门静脉,采用搅拌技术溶解血栓,后留置导管持续应用溶栓药物。术后随访门静脉通畅情况。结果 2例采用经颈静脉途径,3例采用经皮经肝途径,搅拌溶栓后门静脉血流明显较前通畅,经留置导管溶栓后门静脉再通均>90%,无严重并发症发生。随访8~21个月过程中,门静脉血流均通畅,无一例血栓复发。结论搅拌联合经导管直接溶栓治疗非肝硬化急性门静脉血栓安全有效,中期随访过程中能维持门静脉血流通畅。
Objective To investigate the clinical effects of agitation combined with direct catheter thrombolysis in the treatment of acute portal vein thrombosis without cirrhosis. Methods A total of 5 patients with acute portal vein thrombosis without cirrhosis were collected. Intravenous transhepatic portal vein through the liver or transjugular vein was used to dissolve the thrombus with stirring technique. The remaining catheter was used to continue thrombolysis. Postoperative follow-up of portal vein patency. Results Two cases were treated with jugular vein and three cases with percutaneous transhepatic route. The portal vein blood flow was significantly more smooth than before. After thrombolysis, the recanalization of portal vein was> 90%. No serious complications occurred. During the follow-up of 8-21 months, portal vein blood flow was smooth, no case of thrombus recurrence. Conclusion Stirring combined with direct catheter thrombolysis in the treatment of acute portal vein thrombosis without cirrhosis is safe and effective. The portal vein blood flow can be maintained during the mid-term follow-up.