急性肠系膜血管缺血性疾病22例诊疗体会

Diagnostic and therapeutic experiences of 22 cases of acute mesenteric ischemia

目的探讨急性肠系膜血管缺血性疾病(AMI)的诊断及治疗方法。方法回顾性分析我科2002年1月至2012年1月收治的22例急性肠系膜血管缺血性疾病患者的临床资料。结果非手术治疗5例症状、体征均消失,肠道功能恢复治愈出院。13例手术治疗的患者中9例治愈出院,4例因术后发生多器官功能衰竭死亡。4例经选择性肠系膜上动脉置管溶栓治愈出院。结论早期溶栓和及时的坏死肠管切除术对挽救患者的生命有重要意义。选择性肠系膜上动脉置管溶栓治疗具有创伤小、恢复快等特点,具有临床研究的价值。

Objective To explore the diagnostic and therapeutic methods for patients of acute mesenteric ischemia （AMI）. Methods The clinical data of 22 patients with AMI in our hospital from Jan. 2002 to Jan. 2012 were analyzed retrospectively. Results Five patients who received non-operative treatment were cured without any symptoms and signs. Thirteen patients were treated by surgery, of which 9 were cured and 4 died of multiple organ fail- ure （MOF）. Four patients were treated by selective transcatheter thrombolysis via superior mesenteric artery, which were all cured. Conclusion Thrombolysis in early time and prompt enterectomy of the necrosis bowl are of great sig- nificance for the treatment of acute mesenteric ischemia. Selective transcatheter thrombolysis via superior mesenteric artery has the advantages of less trauma, shorter recovery time and better effect, which is of great clinical significance.