急性肠系膜血管闭塞的诊治经验(附16例报告)

Diagnosis and Treatment of Acute Mesenteric Vessel Occlusion—A Report of 16 Cases

目的 探讨急性肠系膜血管闭塞 (AMVO)的早期诊断和治疗。方法 8例急性肠系膜动脉栓塞 (MAE)确诊 5例 ,误诊 3例。保守治疗 1例 ,介入溶栓 1例 ,肠切除 4例 ,取栓后肠切除 1例 ;另 1例大部小肠严重缺血 ,经二次手术探查 ,避免了肠切除和短肠综合征。 8例急性肠系膜静脉血栓形成 (MVT)确诊 4例 ,疑诊 4例 ;保守治疗 2例 ,肠切除 2例 ,取栓后肠切除 4例。结果 8例MAE治愈 5例 ,死亡 3例 ;8例MVT全部治愈。结论 对AMVO保持警惕 ,早期确诊是提高疗效的关键。

Objective To investigate the early diagnosis and treatment of the acute mesenteric vessel occlusion(AMVO).Methods In 8 cases of acute mesenteric arterial embolism(MAE), 5 cases were definitely diagnosed, 3 cases were made error diagnosis. One case was treated non operatively, 1 case was treated by interventional thrombolysis, 4 cases received bowel resection, 1 case received bowel resection after removal of the embolus, the last one avoid bowel resection and short bowel syndrome by the second look operation. In the 8 cases of acute mesenteric venous thrombosis (MVT), 4 cases were definitely diagnosed, 4 cases were suspected. Two cases were treated non operatively, 2 cases received bowel resection, the remaining 4 cases received bowel resection after removal of the thrombus.Results In the 8 cases of MAE, 5 were cured and 3 died. All the 8 cases of MVT recovered. Conclusion Early diagnosis was the key to improve the therapeutic effects of AMVO.