急性肠系膜血管缺血性疾病35例报告

Acute mesenteric ischemia-a kind of acute abdomen was often ignored

目的提高急性肠系膜缺血性疾病(acute mesenteric ischemia,AMI)早期诊断率。方法对1973年至1983年和1997年至2006年的两组35例病例进行分析,针对基础疾病、发病特点、诊断方法及手术效果进行探讨。结果第一组完全依靠普通检查,术前确诊率37%,手术死亡率为61.5%。第二组对可疑病例及早实施影像学筛选,术前确诊率提高到88%,手术死亡率降至12.5%。结论提高早期确诊率的重要因素包括:(1)了解AMI的病理解剖特点;(2)认知AMI发病过程;(3)重视可能导致AMI的基础疾病;(4)强调对可疑病例实施影像学筛查及二次剖腹探查的重要性。

Objective To discuss the diagnosis and management of acute mesenteric ischemia （AMI）. Methods methods, characteristics, and Retrospective analysis was did based on the clinical manifestations, diagnostic operative results of 35 patients with AMI from 1973 to 1983 and from 1997 to 2006. Results The mortality of the first group was 61.5 %, the diagnose rate was 37 %, the general examinations were did in this group;the mortality was 12.5 % in the second group,the diagnose rate was 88 % ,because the imageological examinations were did with the suspect patients. Conclusion The important factors for early diagnosis includes： To recognize the relationship between pathoanatomical characters and clinical diagnosis of AMI, the special onset process of AMI, pay attention to the fundamental diseases,they might lead to AMI, and imageological examination for doubtful cases. Emphasize the importance of the ＂secondary paunch exploration＂.