急性肠系膜血管供血不全的早期诊断和治疗

The clinical study of early diagnosis and treatment on acute mesenteric arterial insufficiency

急性肠系膜血管供血不全在临床急腹症中虽不常见，一旦发生即呈凶险重症。临床常因认识不足而延误诊断和治疗，是近年文献报告死亡高居高不下的主要原因。作者对我院１９６０年至１９９４年急性肠系膜血管供血不全２３例的临床资料进行了分析．指出有外周动脉栓塞史和发生动脉栓塞同时伴有剧烈腹痛和早期出现呕吐伴啡样物和或便血症状，以及腹疼对镇痛剂无效者，应视为肠系膜上动脉供血不足的早期症兆。对早期诊断和治疗进行了综合性讨论。并主张应积极开展肠系膜上动脉切开取栓术。

Abstract:Acute mesenteric arterial insufficiency is uncommon but severe clinical entity,often going unrecognized with poor prognosis. We made a retrospective analysis in 23 such cases documented from 1960~1994 in our hospital. Our study suggested that patients with a history of peripheral artery embolization encounter severeabdominal pain and early gastrointestinal sign (such as vomiting coffee grounds-like gastric content and/or blood stool)and no pain relief with narcotics should be considered as early signs of acute mesenterie arterial insufficiency. Early exploration with mesenteric artery thrombectomy could help in improving patients' otherwise miserable outcome.