Liu Kai, Liu Shousheng, Li Luan, Wang Shikai, Fan Xinxin, Wu Xingjiang, Shi Guangjun, Zong Hongtao
Department of Hepatobiliary Surgery, Qingdao Municipal Hospital, Qingdao, Shandong Province, P. R. China.
Department of Central Laboratory, Qingdao Municipal Hospital, Qingdao, Shandong Province, P. R. China.
Ann Vasc Surg. 2020 May;65:72-81. doi: 10.1016/j.avsg.2019.11.015. Epub 2019 Nov 16.
This retrospective study aims to investigate the effects of the endovascular and surgical strategy for treating patients with acute mesenteric venous thrombosis (AMVT).
We retrospectively studied 68 patients with AMVT who underwent treatment in Jinling Hospital during the period from January 2009 to December 2014. The mean age was 45 ± 12 years (range 20-72 years). All patients were treated by using the combined treatment that included endovascular treatment, damage control surgery, surgical intensive care, and intestinal rehabilitation treatment. Clinical outcomes and complications were compared during the follow-up period.
All the 68 cases received anticoagulant treatment. However, only 24 received the endovascular intervention, 19 received surgical resection, and 25 patients received endovascular treatment combined with bowel resection. The overall mortality rate was 2.94% (2 cases). Bowel resection range significantly decreased (92 ± 14 cm vs. 162 ± 27 cm, t = -2.377, P = 0.022) in the combination therapy group, when compared with the surgery group. During the 1-year follow-up period, 4 cases suffered from short bowel syndrome.
Our study indicates that AMVT can be successfully treated with the early improvement of intestinal blood circulation. Further, our applied combined approach showed a favorable outcome in mesenteric thrombosis patients and reduced the mortality rate by improving the prognosis significantly.
本回顾性研究旨在探讨血管内及手术策略治疗急性肠系膜静脉血栓形成（AMVT）患者的效果。
我们回顾性研究了2009年1月至2014年12月期间在金陵医院接受治疗的68例AMVT患者。平均年龄为45±12岁（范围20 - 72岁）。所有患者均采用包括血管内治疗、损伤控制手术、外科重症监护和肠道康复治疗在内的联合治疗。在随访期间比较临床结局和并发症。
68例患者均接受了抗凝治疗。然而，仅24例接受了血管内介入治疗，19例接受了手术切除，25例患者接受了血管内治疗联合肠切除。总死亡率为2.94%（2例）。与手术组相比，联合治疗组的肠切除范围显著减小（92±14 cm对162±27 cm，t = -2.377，P = 0.022）。在1年的随访期内，4例患者出现短肠综合征。
我们的研究表明，早期改善肠道血液循环可成功治疗AMVT。此外，我们应用的联合方法在肠系膜血栓形成患者中显示出良好的效果，并通过显著改善预后降低了死亡率。
