Abu-Daff S, Abu-Daff N, Al-Shahed M
Department of Surgery, Riyadh Military Hospital, Riyadh, Saudi Arabia.
J Gastrointest Surg. 2009 Jul;13(7):1245-50. doi: 10.1007/s11605-009-0833-7. Epub 2009 Mar 19.
The objective was to study the factors associated with mortality in mesenteric venous thrombosis (MVT).
We reviewed all cases of bowel ischemia at our institute from 1984 to 2004 and identified 31 cases of MVT and compiled data concerning their demographics, risk factors, investigations, management, surgical procedures, and outcomes. Survival was analyzed for both 30-day and 5-year periods.
Analysis of factors associated with mortality in our 31 case series revealed that 30-day mortality was strongly associated with colonic involvement in ischemia (p = .008) as well as short bowel syndrome (p = .028) and possibly failure to anti-coagulate the patient (p = .07). While 5-year mortality was strongly associated with "short bowel syndrome" as defined by small bowel remaining less than 100 cm (p = .031). Further study using a multivariate Cox proportional hazard analysis showed that mortality within the 30-day period was mainly related to colon ischemia with p value of .014 and an odds ratio of 17.4, while short-bowel syndrome was the predominated factor in the 5-year mortality analysis with a p value of .029 and an odds ratio of 5.
Thirty-day mortality for MVT is strongly associated with colonic involvement as well as "short-bowel" syndrome, while anticoagulation may be protective. Five-year survival was found to be strongly associated with "short-bowel" syndrome.
研究肠系膜静脉血栓形成（MVT）患者死亡的相关因素。
我们回顾了我院1984年至2004年所有肠缺血病例，确定了31例MVT患者，并收集了有关其人口统计学、危险因素、检查、治疗、手术操作及预后的数据。分析了30天和5年的生存率。
对我们的31例病例系列中与死亡相关因素的分析显示，30天死亡率与缺血累及结肠（p = 0.008）、短肠综合征（p = 0.028）以及可能未对患者进行抗凝治疗（p = 0.07）密切相关。而5年死亡率与小肠剩余长度小于100 cm所定义的“短肠综合征”密切相关（p = 0.031）。使用多变量Cox比例风险分析的进一步研究表明，30天内的死亡率主要与结肠缺血有关，p值为0.014，比值比为17.4，而在5年死亡率分析中，短肠综合征是主要因素，p值为0.029，比值比为5。
MVT的30天死亡率与结肠受累以及“短肠”综合征密切相关，而抗凝治疗可能具有保护作用。发现5年生存率与“短肠”综合征密切相关。
