血运性肠梗阻致急性肠坏死13例临床分析

Clinical analysis of vascular ileus causing acute intestinal necrosis

目的 探讨血运性肠梗阻并发急性肠坏死的发病机制、临床表现及诊治方法。方法 对 2 0 0 0～ 2 0 0 3年间 13例因急性血运性肠梗阻至急性肠坏死住院患者的临床表现、诊疗过程进行回顾性分析。结果 术前确诊仅 2例 ,治愈 7例 ,好转 3例 ,死亡 3例。死亡原因 :感染性休克和弥漫性血管内凝血 2例 ,肺栓塞及多器官功能衰竭 1例。结论 该病临床表现以急性腹部疼痛为特点 ,极易误诊为其他急腹症。早期诊断、即时手术、术中及术后抗凝是改善预后的关键。

Objective To investigate the pathogenesis,clinical situation and mesthods of diagnosis and therapy on vascular ileus.Methods Retrospective analysis the clinical situation,process of diagnosis and therapy and prognosis of 13 cases patients with acute vascular ileus from 2000 to 2004.Results Only two cases were diagnosed before operation,seven cases were cured,three cases were improve,three cases were dead.Death reason:two cases with infectious shock and disseminated inravascular coagulation,one case with pulmonary embolism and multiple organ failure.Conclusion Abdominal pain is the character of clinical situation of the disease,especially misdiagnose to other acute abdomen.Early diagnosis,emergency operation,intraoperative and postoperative anticoagulant therapy is key point of improve prognosis.