15例肠系膜上动脉压迫综合征的影像诊断及PEJ肠内营养支持治疗的分析报告

The Radiology Diagnosis and PEJ Enteral Nutrition Treatment of Superior Mesenteric Artery Syndrome Basing on 15 Patients

目的:探讨肠系膜上动脉压迫综合征病人的影像学表现和PEJ肠内营养支持治疗的疗效。方法:通过对15例SMACS患者的临床资料、诊疗过程和临床疗效的全面回顾和分析,探讨和评估该疾病的临床影像诊断方法与PEJ治疗方案的综合疗效。结果:综合影像诊断能够确诊肠系膜上动脉压迫综合征,经PEJ肠内营养支持治疗6个月后,10例(66.67%)患者体重体明显增加(>5 kg)。13例(86.67%)患者复查上消化道钡餐,上消化道症状明显减轻,无明显不良反应。结论:实践证明,从病理影像学和影像解剖学的综合分析角度,分别采用钡餐造影、多层螺旋CT血管成像、B型超声检查共三种影像学技术的诊断,结合患者的病史及临床表现,可以确诊肠系膜上动脉压迫综合征。通过运用通过经皮内镜下胃造口空肠置管术(PEJ)营养支持治疗技术将肠内营养液输注至梗阻远端正常肠管,且能够避免多种并发症,使本组患者得以基本康复。

Objective： To investigate imaging findings of superior mesenteric artery compression syndrome and PEJ treatment program efficacy. Methods： By reviewing and analyzing the clinical data, treatment process and the clinical efficacy of 15 cases of superior mesenteric artery syndrome （SMACS） patients, the diagnosis and PEJ treatment program efficacy were explored and assessed. Results： Integrated image diagnosis can diagnose superior mesenteric artery compression syndrome. The PEJ enteral nutrition support treatment for more than 6 months, 10 patients （66.67%） were significantly increased body weight （〉 5 kg）, upper gastrointestinal symptoms in 13 cases （86.67%） patients reviewed by upper gastrointestinal barium meal were reduced, and had no obvious adverse reaction. Conclusion： Clinical practice has proved that by using the comprehension of three different medical imaging examination： barium meal, multi-slice spiral CT angiography, B ultrasound, combined with the patient history and clinical manifestation, we can confirm the diagnosis of SMACS. Using PEJ treatment program can directivity infuse the enteral nutrition to the normal bowel below the obstruction site, which can significantly enhance the nutritional status of the patient, therefore this treatment protocol can get success in curing the disease and avoiding a variety of complication.