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Acute intestinal membrane venous thrombosis (AMVT) accounts for 5% to 15% of acute intestinal membrane isosis cases and has a mortality rate of up to 10%.
AMVT is characterized by a hidden disease, rapid progression, and nonse specific abdominal symptoms at an early stage.
irreversible intestinal isoemia seriously affects the prognosis of AMVT.
the main goal of AMVT therapy is to re-open early to prevent irreversible intestinal isoemia.
Immediate anticoagulants are the first step and cornerstone of treatment strategies, and early anticoagulants have been shown to lead to 80% vascular recombment and reduced mortality, but for patients with intestinal necrosis and severe sepsis, caesarean sections, including intestinal excision and open abscesses, may eventually be required to control damage, some studies have shown Positive transductive thrombosis (TT) can improve the treatment results of AMVT, however, irreversible intestinal ischemicemia is still the main cause of poor prognosis, irreversible intestinal ischemic risk factors are not clear, this study is designed to assess the TT treatment of AMVT patients in need of surgical removal of irreversible intestinal ischemic clinical results and determine predictive factors.
reviewed clinical records of AMVT patients who received TT treatment continuously from January 2010 to October 2017.
patients who had irreversible bowel isemia were compared to those who did not need to have their intestines removed.
study found that in 58 patients, all patients had an immediate TT of 28.5 h after hospitalization.
42 patients (72.4%) received venous combined thrombosis, while 16 (27.6%) received arterial thrombosis therapy only.
mortality rate for 30 days was 8.6 per cent.
32 patients (55.2%) had irreversible intestinal isoemia, with a higher mortality rate of 30 d and longer hospital stays than those who did not have it removed.
independent predictive factor for irreversible bowel ischemic is the Acute Physiological and Chronic Health Assessment (APACHE) II score (advantage ratio: 2.368, 95% CI: 1.047-5.357, P - 0.038) and lebespherics (advantage ratio - 2.058, 95% CI: 1.085-3.903, P - 0.027).
TT can be effective in AMVT patients, the researchers concluded.
APACHE II score and increased white blood cells can significantly predict irreversible intestinal ischemic occurrence.
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