| Objectives:To investigate the clinical features of acute mesenteric venous thrombosis,select appropriate diagnostic methods and treatment options to avoid misdiagnosis and reduce the mortality of the disease.Methods:27 patients with AMVT admitted to the Vascular Surgery Department of the Affiliated Qianfoshan Hospital of Shandong University from January 2014 to August 2017 were taken as research objects.The related clinical data of the patients,such as age,gender,pathogenies and inducements,symptoms and signs,auxiliary examinations,treatment process and results,prognosis,etc.were collected.According to the prognoses of 27 patients,they were divided into two groups:the cure group and the death group.The above data were summarized and analyzed,and relevant data were processed statistically.Results:A total of 17 male patients and 10 female patients with AMVT were collected in this study with a male to female ratio of 1.70:1.The age of onset was 36 to 78 years,and the median age was 57 years,with an average age of(55.67±11.32)years.Among them,there were 7 cases with a history of VTE,accounting for 25.93%,6 cases in the postoperation of splenectomy due to liver cirrhosis,accounting for 22.22%,3 cases of hypertension,accounting for 11.11%,3 cases of coronary heart disease,accounting for 11.11%,2 cases of diabetes,accounting for 7.41%,2 cases of malignant tumor,accounting for 7.41%;and there are 1 case of postoperative appendectomy,rheumatoid arthritis,hyperthyroidism,and chronic bronchitis,each of which accounted for 3.70%;there were 5 cases without obvious previous history,accounting for 18.52%.27 patients had abdominal pain of varying degrees at admission,16 patients had symptoms of nausea and vomiting,12 patients had varying degrees of abdominal distension,6 patients had a body temperature>37.5?,and 4 patients had hematemesis and tarry stools.After admission,27 patients were performed routine examination such as blood routine examination,D-dimer determination,etc.Among them,white blood cell counts of 20 patients>9.5×109/L(3.5-9.5×109/L),and D-dimer measured values of 23 patients>0.55 mg/L(0-0.55 mg/L).6 patients underwent abdominal puncture and all had hemorrhagic ascites.All patients were diagnosed as AMVT by color Doppler ultrasound,CTA and other tests.For the onset was less than 3 days,there were 11 patients in treatment,of whom 5 were cured and 6 died.The mortality rate was 54.55%.For the onset was more than 3 days,there were 16 patients in treatment,of whom 14 were cured and 2 died.The mortality rate was 12.50%.The onset time and the patients' cure conditions conform to statistical significance(P<0.05).The onset time and D-dimer content didn't have statistically significance.19 patients in the cured group,4 accepted the simple conservative treatment,10 accepted surgical treatment,and 5 accepted the interventional therapy.Among the patients undergoing interventional therapy,3 patients were treated by surgery due to signs of intestinal necrosis;8 patients in the death group,0 case accepted conservative treatment,6 cases accepted surgical treatment,and 2 cases accepted interventional therapy.In patients undergoing interventional therapy,1 case was undergone surgical treatment due to signs of intestinal necrosis.Conclusion:1.AMVT is more closely related to abdominal surgery,and VTE medical history.When patients suffer from abdominal pain and they are accompanied with the above-mentioned medical history,the possibility of AMVT should be considered.2.As to patients whose symptoms are only abdominal pain,with no peritoneal irritation sign,when conducting drug therapy and interventional therapy,closely monitor the progress of disease and prepare for emergency laparotomy at any time.3.Prognosis of the disease depends on factors like the part,range,the time between onset and surgery of mesenteric venous thrombosis.Although AMVT belongs to serious acute abdominal disease,it can be cured with timely and accurate diagnosis and treatment. |
PDF Full Text Request