急性肠系膜血管缺血性疾病诊断及治疗的分析

Analysis of the Diagnosis and Management of Acute Mesenteric Ischemia

目的：探讨急性肠系膜血管缺血性疾病的诊断和治疗。方法：回顾性分析1993年7月至2000年7月急性肠系膜缺血性疾病19例临床资料。结果：19例均经病理证实。初诊时多因表现为急腹症，症状与体症不符和缺乏特异性检查而误诊。18例手术治疗，其中15例治愈，3例死亡。另1例因误诊时间过长未能及时手术终导致死亡。结论：选择性动脉造影和腹部CT是较敏感的检查，对诊断有积极作用。早期适当范围切除坏死肠段和术后抗凝治疗是防止复发、降低病死率的重要措施。

Objective: To explore the diagnosis and management of acute mesenteric ischemia (AMI). Method: Clinical data of 19 patients with AMI in the last 3 years were analyzed retrospectively. Results: All cases were diagnosed pathologically. Most of the patients were misdiagnosed at first owing to the appearance of acute abdominal pain，the inconsistency of symptoms and signs, and the lack of specific examination. 18 patients received operations (15 recovery, 3 die). 1 patient died of misdiagnosis for too long a time to receive an operation in time. Conclusions: Selective angiography and abdomen CT are effective examinations on the diagnosis of AMI. Early reseation of necrotic bowel and application of anticoagulant postoperatively are essential to reduce the mortality and recurrence of AMI.