急性肠系膜缺血所致的急腹症(附22例报告)

Acute abdomen caused by acute mesenteric ischemia (a report of 22 cases)

目的总结急性肠系膜缺血(AMI)所致急腹症的临床特征并探讨提高疗效的措施。方法回顾性总结22例AMI的临床特点、治疗方法及其预后的关系。结果AMI病人大多属于高龄,常伴有心血管疾病,病情危急多变,缺乏特异表现,其术前误诊率、病死率和致残率分别为72.7%、36.4%和21.4%。结论加强对AMI病理生理的认识,选择合适的影像学检查等以提高早期确诊率,及时给予以手术为主的综合治疗是提高疗效的关键。

Objective To investigate the clinical characteristics of acute abdomen caused by acute mesenteric ischemia (AMI) and the therapeutic strategy to improve the outcome. Methods Relationship between the clinical characteristics, therapeutic modalities and prognosis of 22 cases of AMI were analysed retrospectively. Results Most of the cases in our group were aged patients with cardiovascular diseases. They were in critical conditions without characteristic signs and symptoms. The misdiagnosis, mortality and disabling rates were 72.7%, 36.4% and 21.4% respectively. Conclusions The key points to improve the outcome of AMI are to achive more understarding of the pathophysiology of AMI, to provide early diagnosis by suitable imaging techniques and to give comprehensive surgical treatment promptly.