Objective To compare the clinical effects of catheter-directed thrombolytic therapy for acute superior mesenteric vein thrombus (SMVT) between via superior mesenteric vein (SMV) route and via superior mesenteric artery (SMA) route. Methods The clinical data of 32 patients with acute SMVT, who were treated with catheter-directed thrombolytic therapy at the Central Hospital of Shengli Oil Field, were retrospectively analyzed. Among the 32 patients, percutaneous transhepatic catheter-directed thrombolytic therapy via SMV route was performed in 23 (SMV group), and percutaneous transhepatic catheter-directed thrombolytic therapy via SMA route was carried out in 9 (SMA group). Results After the treatment, the clinical symptoms were significantly improved in 28 patients, including 22 of SMV group (95.7%) and 6 of SMA group (66.7%). CT angiography showed that the blood flow became almost complete patency in 17 patients of SMV group (73.9%) and in only 3 patients of SMA group (33.3%). Both the thrombolysis procedure time and X-ray exposure time of SMV group were obviously longer than those of SMA group. Conclusion Both via SMV and via SMA catheter-directed thrombolytic therapies are effective treatment for acute SMV thrombosis. The former is more effective, while the manipulation of the latter is technically simpler.%目的 对比分析经肠系膜上静脉导管溶栓和经肠系膜上动脉导管溶栓治疗急性肠系膜上静脉血栓形成(SMVT)的临床效果.方法 回顾性分析胜利油田中心医院收治的32例急性SMVT患者,其中23例接受经皮肝穿刺肠系膜上静脉导管溶栓治疗(经静脉溶栓组),9例接受经皮股动脉穿刺肠系膜上动脉导管溶栓治疗(经动脉溶栓组).结果 28例患者临床症状有明显改善,其中经静脉溶栓组患者22例, 经动脉溶栓组患者6例.CTA检查显示经静脉溶栓组17例患者肠系膜上静脉血流大部分再通,经动脉溶栓组仅有3例大部分再通.经静脉溶栓组导管溶栓操作时间和曝光时间均明显长于经动脉溶栓组.结论 经肠系膜上静脉导管溶栓及经肠系膜上动脉导管溶栓均为治疗急性SMVT的有效方法,前者临床效果更加理想,后者在操作上更为简便.
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