One case of severe acute pancreatitis complicated with portal vein system extensive thrombosis
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摘要: 重症急性胰腺炎并发门静脉系统广泛血栓并不少见，但病情凶险，诊治困难。本文报道1例重症急性胰腺炎并发门静脉系统广泛血栓，临床表现为发病后迅速出现消化道出血和急性肝功能衰竭，但通过坚持抗凝及其他综合性治疗获得成功。本文将此病例进行报道，旨在为此类患者的诊治提供借鉴和参考。Abstract: Severe acute pancreatitis complicated with portal vein system thrombosis is not rare, but it is dangerous and difficult to diagnose and treat. This paper reports a case of severe acute pancreatitis complicated with portal vein system thrombosis. The clinical manifestations were gastrointestinal bleeding and acute liver failure immediately after the onset, but the patient was successfully treated with anticoagulation and other comprehensive treatments. We report this case in order to provide reference for diagnosis and treatment in these patients.
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表 1 抗凝前后10 d相关实验室指标的变化
实验室指标 抗凝前
(入院
第1天)抗凝前
(入院
第2天)抗凝第1天
(入院
第2天)抗凝
第2天抗凝
第3天抗凝
第4天抗凝
第5天抗凝
第6天抗凝
第7天抗凝
第8天抗凝
第10天PT/s 16.1 37.8 35.7 30.4 29.0 19.3 16.3 17.2 - 16.2 16.5 APTT/s 32.8 57.8 78.5 63.9 69.6 54.6 35.8 64.1 68.8 68.3 50.5 INR 1.27 3.75 3.48 2.83 2.67 1.59 1.29 1.38 - 1.28 1.30 FIB/(g/L) 3.94 2.44 2.01 1.86 1.96 2.15 1.96 1.53 - 2.60 3.10 D-D/(mg/L) 15.89 15.09 17.70 >20.00 19.54 14.75 11.78 11.21 - 13.88 7.88 HGB/(g/L) 154 104 - 92 90 96 96 92 65 84 71 PLT/(×109/L) 213 124 - 79 51 36 61 36 37 56 101 ALT/(U/L) 12 457 3 296 4 136 2 649 1 619 675 290 138 65 34 TB/(μmol/L) 27.0 26.7 47.0 84.3 115.7 116.0 99.5 102.5 96.3 83.9 63.9 注：ALT：丙氨酸氨基转移酶；TB：总胆红素。 
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