急性肠系膜动脉缺血性疾病的诊治分析——附27例报道

Therapy for acute mesenteric artery ischemia:a clinical study of 27 cases

目的:探讨急性肠系膜动脉缺血的诊断和治疗方法。方法:回顾性分析自2002年5月至2008年12月我院共收治肠系膜动脉缺血性疾病患者27例。急诊行手术治疗21例,其中单纯行肠系膜上动脉取栓术9例,肠系膜上动脉切开取栓加肠切除吻合术8例,单纯肠切除吻合术3例,肠切除加肠造瘘术1例。保守治疗6例。结果:手术治疗21例,1例于死于感染性休克,5例出现短肠综合征,经胃肠外营养等对症治疗后症愈出院,6例行保守治疗者均症状减轻,好转出院。结论:彩超是早期诊断肠系膜动脉缺血的重要手段,及时手术和加强术后监护是提高疗效的关键。

Objective：To investigate the diagnosis and theray of acute mesenteric artery ischemia. Method： The clinic data of 27 patients with acute mesenretic artery ischemia between 2002 and 2008 were retrospectively analyzed. Emergency operation were performed on 21 patients, including embolectomy on 9 cases, embolectomy and intestinal resection on 8 cases, intestinal resection and anastomosis on 3 cases, intestinal resection and enterestomy on I case., expectant treatment on 6 cases. Result： 1 patient died of septic shock after the opetion, short bowel syndrome was found in 5 patienets and all were cured after parenteral alimentation, the 6 patients who received expectant treatment were all improved and discharged. Conclusion ： Ultrasound is important for the diagnosis of mesenteric artery ischemia, timely operation and intensive care play important rules in the therapy.