肠系膜上动脉压迫综合征20例报告

The experience of surgical treatment for 20 cases of superior mesenteric artery syndrome

目的探讨肠系膜上动脉压迫综合征(superior mesenteric artery syndrome,SMAS)的术式选择。方法对我院2000年1月至2007年12月期间收治的行手术治疗的20例SMAS的临床资料进行回顾性分析。结果本组行Treitz韧带松解加十二指肠空肠侧侧吻合术9例,Treitz韧带松解加十二指肠空肠Roux-en-Y吻合术5例,均痊愈;行胃大部切除、胃空肠吻合术4例,均好转;单纯胃空肠吻合术2例,术后症状均仅有所改善,1例改行十二指肠空肠Roux-en-Y吻合术后痊愈,另1例非手术治疗1个月后治愈。结论SMAS的手术治疗效果以Treitz韧带松解加十二指肠空肠吻合术为最佳。

Objective To approach the surgical procedures for superior mesenteric artery syndrome （SMAS）. Methods The clinical data of 28 cases of SMAS from Jan. 2000 to Dec. 2007 were analyzed retrospectively. Results All patients underwent barium meal examination. Among the 28 case of SMAS, 20 cases were subieeted to surgical procedures, and the remaining 8 cases underwent conserva- tive treatment. The surgical procedures for these patients included lysis of the Treitz ligament and side- to-side duodenoiejunostomy in 9 cases, lysis of the Treitz ligament and Roux-en-Y duodenojejunostomy in 5 cases, and all of them were cured. Of 6 cases subject to gastroiejunal anastomosis, 4 cases got improvement, and 2 case had recurrence. Conclusion Duodenojejunal anastomosis has a better outcome for SMAS.