12例缺血性肠病的临床分析

Clinical analysis of 12 cases of ischemic bowel disease

目的分析缺血性肠病(ischemic bowel disease,IBD)的临床特点、诊断及治疗。方法回顾性分析12例患者临床表现、合并症、腹部血管CT成像(CT angiography,CTA)或腹部血管彩超、电子结肠镜、治疗等。结果急性缺血性肠病3例,2例经手术治疗,1例发病72 h内死亡。慢性缺血性肠病9例,8例经内科治疗好转,1例死亡。结论急性缺血性肠病多见于肠系膜上动脉闭塞,早诊断、早治疗较重要,出现肠坏死预后差。慢性性缺血性肠病多见于肠系膜上、下动脉狭窄及灌注不足,内科治疗疗效良好。肠道排空障碍可能是IBD的早期表现。

Objective To investigate the clinical charactristic, diagnosis and treatment of ischemic bowel disease （IBD）. Methods The clinical manifestations, complications, computed tomography angiography （CTA） of abdomen/ vascular color Doppler ultrasound of abdomen, diagnosis, treatment of 12 cases of IBD patients were analyzed retrospectively. Results Three cases were acute ischemic bowel disease, 2 cases were operated, 1 case died in 72 h. Nine ca- ses were chronic ischemic bowel disease, 8 cases were cured by medical treatment , 1 case died from infection. Conclusion Early diagnosis and treatment are important for acute ischemic bowel disease which tend to attack superior mensenteric artery. Medical treatment has good effects in chronic ischemic bowel disease which tend to attack inferior mensenteric artery. Dysfunction of emptying of intestine may be the feature of IBD in early stage.