肠系膜上动脉压迫综合征的诊断和治疗

Diagnosis and treatment of superior mesenteric artery syndrome

目的探讨肠系膜上动脉压迫综合征的病因、诊断和治疗方法。方法对1980年1月至2008年10月我院普外科收治的32例肠系膜上动脉压迫综合征的临床资料进行回顾性分析。结果本组均采用十二指肠空肠Roux-en-Y侧侧吻合加Treitz韧带松解术行手术治疗,术后病人症状均得到缓解,无死亡病例和并发症发生。结论肠系膜上动脉压迫综合征的主要确诊手段为X线钡餐造影;对保守治疗无效可采用手术治疗,十二指肠空肠侧侧Roux-en-Y吻合加Treitz韧带松解术为理想术式。

Objective To analyze the etiology, diagnosis and treatment of superior mesenteric artery syndrome（SMAS）. Methods The clinical data of 32 SMAS patients admitted to the general surgical department of our hospital from Jan. 1980 to Oct. 2008 were analyzed retrospectively. Results All the 32 cases underwent surgical procedures： Roux-en-Y side-to-side duodenojejunostomy with Amputation of Treitz ligament. All the 32 cases were cured, and there were no complications and deaths. Conclusion The diagnosis of SMAS should mainly depend on barium meal examination except the typical clinical manifestations such as epigastric distending pain and vomiting. Conservative treatment should be chosen primarily, and the Roux-en-Y side-to-side duodenojejunostomy with amputation of Treitz ligament is an appropriate procedure for the obstinate SMAS by non-operation treatment.