CAJ | 학술논문

目的：提高对易栓症临床特点的认识，以减少误漏诊。方法回顾分析1例以肠梗阻为首发表现最终确诊为易栓症的临床资料，并复习相关文献。结果本例因慢性不全性肠梗阻入院，有下肢深静脉血栓形成病史，本次发病在外院行影像学检查示门静脉及肠系膜上静脉血栓形成，予溶栓抗凝治疗，肠梗阻症状仍持续存在。转我院后经详细询问病史，明确家族性血栓疾病史，查同型半胱氨酸、蛋白C、蛋白S、抗蛋白酶芋及活化蛋白C抵抗均异常，确诊为遗传性易栓症。后因肠梗阻转外科行肠切除、肠吻合术，术后予低分子肝素治疗，患者恢复良好，痊愈出院。结论累及腹部血管的易栓症文献报道较少，提示临床医师对腹腔内静脉血栓形成者应警惕易栓症可能，以早期诊治。
목적：제고대역전증림상특점적인식，이감소오루진。방법회고분석1례이장경조위수발표현최종학진위역전증적림상자료，병복습상관문헌。결과본례인만성불전성장경조입원，유하지심정맥혈전형성병사，본차발병재외원행영상학검사시문정맥급장계막상정맥혈전형성，여용전항응치료，장경조증상잉지속존재。전아원후경상세순문병사，명학가족성혈전질병사，사동형반광안산、단백C、단백S、항단백매우급활화단백C저항균이상，학진위유전성역전증。후인장경조전외과행장절제、장문합술，술후여저분자간소치료，환자회복량호，전유출원。결론루급복부혈관적역전증문헌보도교소，제시림상의사대복강내정맥혈전형성자응경척역전증가능，이조기진치。
Objective To improve the recognition about the clinical characteristics of thrombophilia, and decrease the misdiagnosis. Methods The clinical features of a case of thrombophilia started with intestinal obstruction symptoms was retro-spectively analyzed and pertinent literature was reviewed. Results The patient was admitted to hospital for the symptoms of chronic incomplete intestinal obstruction, with previous history of lower limb deep vein thrombosis. The imaging signs outside the hospital showed portal vein (PV) and superior mesenteric vein (SMV) thrombosis, and intestinal obstruction symptoms in the patient persisted after given with thrombolysis and anticoagulation therapy. After transferring to our hospital and learning his fa-milial history of thrombotic disease, we checked the homocysteine assay, protein C, protein S, anti-proteaseⅢand activated protein C, and the results were all abnormal, and then inherited thrombophilia was diagnosed. The patient was transferred to sur-gical department and underwent bowel resection and anastomosis, and postoperative recovery was good. Conclusion Thrombo-philia involving abdominal vascular is reported in less clinical literature, clinicians should be alert to the possibility of the throm-bophilia in patients with intra-abdominal venous thrombosis in order to achieve the purpose of early diagnosis and treatment.