中国普通外科杂志2025，Vol.34Issue(12)：2619-2626,8.DOI:10.7659/j.issn.1005-6947.250158
经腹直视肠系膜上静脉入路AngioJet联合球囊扩张治疗急性门静脉血栓的临床研究
AngioJet thrombectomy combined with balloon dilation via a direct transabdominal superior mesenteric vein approach for acute portal venous system thrombosis
摘要
Abstract
Background and Aims:Acute portal venous system thrombosis may lead to life-threatening complications such as intestinal necrosis and variceal bleeding,while anticoagulation alone often results in a low recanalization rate.This study evaluated the safety and efficacy of direct transabdominal superior mesenteric vein puncture combined with AngioJet mechanical thrombectomy and balloon angioplasty for acute portal venous system thrombosis. Methods:A retrospective analysis was conducted on 10 consecutive patients with acute superior mesenteric vein-portal vein thrombosis treated between July 2023 and December 2024.All patients underwent direct puncture of the superior mesenteric vein through a small midline laparotomy under general anesthesia,followed by AngioJet mechanical thrombectomy and adjunctive balloon angioplasty.Immediate thrombus clearance,perioperative outcomes,and follow-up recanalization were evaluated. Results:The median operative time was 140(110-245)minutes,and the median intraoperative blood loss excluding AngioJet-related hemolysis was 80(50-200)mL.The median thrombus aspiration time using the AngioJet mechanical thrombectomy system was 173(138-296)s.Immediate postoperative thrombus clearance was grade Ⅲ in 7 patients and grade Ⅱ in 3 patients,yielding a technical success rate of 100%.Perioperative complications included one case of intraperitoneal bleeding and one wound hematoma.All patients experienced significant relief of abdominal pain,with no intestinal necrosis,bowel obstruction,or acute renal failure.During a median follow-up of 5 months,complete portal venous system recanalization was achieved in 5 patients,partial recanalization in 4 cases,and stable thrombosis in 1 case,with no recurrence,anticoagulation-related bleeding,or mortality. Conclusion:Direct transabdominal puncture of the superior mesenteric vein combined with AngioJet thrombectomy and balloon angioplasty is a safe and effective treatment for extensive acute portal venous system thrombosis,enabling rapid restoration of portal flow and prevention of intestinal ischemic complications.关键词
静脉血栓形成/肠系膜静脉/门静脉/血栓切除术/机械溶栓Key words
Venous Thrombosis/Mesenteric Veins/Portal Vein/Thrombectomy/Mechanical Thrombolysis分类
医药卫生引用本文复制引用
李伟浩,张学民,张韬,李晶,张小明..经腹直视肠系膜上静脉入路AngioJet联合球囊扩张治疗急性门静脉血栓的临床研究[J].中国普通外科杂志,2025,34(12):2619-2626,8.基金项目
北京大学人民医院研究与发展基金资助项目(RDJP2023-14). （RDJP2023-14）
