急性肠系膜血管缺血性疾病的早期诊治探讨

Early diagnosis and treatment of the acute mesenteric ischemia disease

目的探讨急性肠系膜血管缺血性疾病的早期诊断和治疗方法。方法回顾性总结１９６５～１９９９年急性肠系膜血管缺 血性疾病的３９例临床资料，分析其诊断和治疗方法。结果 器质性心脏病、动脉硬化、血栓等病史伴有与腹部体征不相符的 剧烈腹痛，应首先考虑肠系膜血管缺血。结论 选择性动脉造影和给药是早期诊断、治疗最有价值的方法，血Ｄ－Ｄｉｍｅｒ是实验 室检查血栓形成的敏感指标。及早应用抗凝、溶栓和罂粟硷等药物是避免手术治疗和预防术后复发的有效方法。

Objective To explore the methods of the early diagnosis and treatment of acute mesenteric ischemia disease. Methods We made a retrospective analysis in 39 cases with the acute mesenteric ischemia disease documented in 1965~ 1999 in our hospital. Results Our study suggested that patients with a history of organic cardiopathy, artherosclerosis and thrombosis who encounted severe abdominal pain and showed no pain relief with narcotics shoud be primarily considered the acute mesenteric ihchemia disease. Conclusion The application of selective angiography and antithrombotic drugs is the most valuable method in early diagnosis and treatment. D-Dimer of blood is the up-to-date and the most sensitive laborato- ry examination. Early application of antithrombotic drugs and vasodilator substances such as papaveraldine is an effective method that can avoid surgical therapy and prevent from recurrence after operation.