[对患有大质量介质静脉血栓症的患者的治疗]
A I Khripun1, A D Pryamikov1,2, A B Mironkov1,2
1Russian National Research Medical University named after N.I. Pirogov , 117997, Moscow, Russian Federation.
概括
中腹静脉血栓形成 (MVT) 可以导致急性肠道缺血症. 通过CT扫描和腹腔镜的早期诊断,结合抗凝剂治疗,改善了结果,并可能防止肠切除.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 中腹静脉血栓形成 (MVT) 是急性肠道缺血和的原因.
- 移植中心血栓,一个严重的变体,有较差的预后.
- 尽管使用抗凝剂治疗,肠切除率仍然很高 (17-91%),死亡率很高 (41%).
研究的目的:
- 分析中枢和中枢端静脉血栓的诊断方法.
- 评估这些疾病患者的各种治疗策略.
主要方法:
- 对25名MVT患者的回顾性分析.
- 诊断方法包括腹腔镜 (n=10),腹腔切除术 (n=6) 和对比增强CT (n=9).
- 治疗策略包括使用抗凝血剂 (n=19) 和手术切除 (n=6) 的保守管理.
主要成果:
- MVT占急性肠道缺血病例的7.7%.
- 整体住院死亡率为28% (7/25名患者).
- 经过手术的患者 (50%) 与保守治疗的患者 (21%) 的死亡率更高,以及大规模的中枢静脉瘤 (36%) 与上枢中枢静脉瘤 (21%).
结论:
- 增强对比度CT和诊断性腹腔镜是诊断MVT的关键.
- 抗凝剂治疗对于预防肠道炎和改善患者的治疗结果至关重要.
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