本文選題：腸系膜靜脈血栓　切入點(diǎn)：誘發(fā)因素　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：回顧分析36例腸系膜靜脈血栓(MVT)的臨床資料,總結(jié)MVT的臨床診治經(jīng)驗(yàn),以及提高臨床醫(yī)師對(duì)MVT的認(rèn)識(shí)。方法：收集重慶醫(yī)科大學(xué)附屬第一醫(yī)院血管外科2006年1月—2014年12月的36例MVT臨床資料,采用百分比和頻率分布描述分析,分析其一般資料、誘發(fā)因素、臨床特點(diǎn)、實(shí)驗(yàn)室檢查及影像學(xué)表現(xiàn)以及治療方法與轉(zhuǎn)歸。結(jié)果：本組資料MVT總死亡5例,死亡率是13.9%,其中1例保守治療過(guò)程中并發(fā)肺栓塞和肺部感染,死于ARDS;手術(shù)后死亡3例,其中2例再次手術(shù)治療后死于全身嚴(yán)重感染合并急性腎衰竭,1例入院急診手術(shù)48h內(nèi)死于MODS:1例死于介入溶栓治療后嚴(yán)重顱內(nèi)出血。保守治療15例,14例治療好轉(zhuǎn)出院；15例手術(shù)治療(入院時(shí)腹部查體彌漫性腹膜炎癥；保守治療后病情反復(fù)并惡化出現(xiàn)并發(fā)癥),治療好轉(zhuǎn)出院12例,5例再次手術(shù)；介入治療6例,治療好轉(zhuǎn)出院5例,2例再次手術(shù)。結(jié)論：1.MVT臨床上仍有一定死亡率,其發(fā)生機(jī)制與臨床經(jīng)過(guò)仍需進(jìn)一步的研究。2.抗凝治療仍然是MVT的重要治療手段,抑制胃腸液和胃腸外營(yíng)養(yǎng)等基礎(chǔ)支持治療是MVT(特別是住院時(shí)間長(zhǎng),腸道功能恢復(fù)慢)患者的必要手段。3.手術(shù)治療僅僅適用于MVT引起的嚴(yán)重并發(fā)癥如腸壞死、腸穿孔和腸梗阻等。4.溶栓和手術(shù)血栓清除治療的療效需要進(jìn)一步觀察。
[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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉暴,李擁軍,鄭日宏,劉昌偉,何小東,鄭朝紀(jì),趙玉沛,管珩;腸系膜靜脈血栓診治(附11例病例分析)[J];中國(guó)醫(yī)學(xué)科學(xué)院學(xué)報(bào);2003年02期

2 張玉國(guó),王嘉桔,許凱,王永安;腸系膜靜脈血栓的診斷及治療體會(huì)[J];中國(guó)現(xiàn)代普通外科進(jìn)展;2004年04期

3 李新;仝現(xiàn)州;張U，

本文編號(hào)：1609444