Early Pathophysiological Research Of Acute Superior Mesenteric Venous Thrombosis And Its Related Study On Thrombolytic Therapy

Objective1.A retrospective clinical analysis was performed to summarize our experience in the treatment of acute mesenteric venous thrombosis in the past few years,and to evaluate the safety and efficacy of thrombolytic therapy combined with surgery in the treatment of such diseases;2.The animal model of ASMVT was established by minimally endovascular technique in order to avoid the surgical stress caused by the traditional method,and to evaluate the pathophysiology of ASMVT;3.To understand the dynamic changes of the development of ASMVT,and to detect the serum markers in the early stage of the disease;to evaluate the effect of thrombolytic therapy in the treatment of ASMVT;4.To study the protective effect of thrombolytic drug t-PA on intestinal ischemia of mesenteric venous thrombosis,and to analyze the clinical significance of anti-fibrosis.MethodsThis study followed the concept of translational medicine.Firstly,summarize our clinical experience and find clinical problem.Secondly,build the animal model and observe its pathophysiological development and early changes of serological markers,to evaluate the protective effect and anti-fibrosis effect for ischemic intestine.Results1.In the retrospective analysis,we summarized the high risk factors and clinical features of ASMVT patients admitted in the past 5 years.Under the guidance of the treatment mode,24 cases were cured simply by endovascular treatment,with 19 cases by surgery alone.25 patients received endovascular treatment combined with surgery,including 6 cases temporary abdominal closure.The overall mortality rate was 2.94%during hospitalization(2/68).The range of bowel resection significantly reduced,comparing endovascular treatment combined with surgery group with surgery alone group.The combined therapy is beneficial to the prognosis of ASMVT patients.2.By using minimally invasive endovascular techniques,we successfully constructed the animal model of ASMVT,to avoid the surgical stress of traditional model,largely simulate the development of the disease,and provide a model for the next research.3.In early serological markers of ASMVT,IFABP was the highest peak in 2h immediately,followed is GST in 6h,D-dimer and D-lactate in 8h,finally LDH is the slowest.Early thrombolytic therapy can effectively improve the blood supply of the intestine,and can protect the ischemic intestine.4.t-PA has a positive correlation with IFABP,and t-PA may play a protective role in ischemic bowel.The expression of TGF-? and ?-SMA was negatively correlated with the expression of t-PA,t-PA has anti-fibrotic effect on ischemic intestine.ConclusionTimely diagnosis and reasonable choice of thrombolytic therapy can improve the intestinal function of ASMVT,and the rational application of thrombolytic drug t-PA has anti-fibrotic effect on ischemic intestine.