肠系膜血管病变引起的急腹症八例报告

Acute abdomen caused by mesenteric vascular lesions 8 cases report

目的 全面认识肠系膜血管病变引起的急腹症的严重性 ,提高疗效。方法 对 8例临床特点、治疗方法和效果进行了分析比较。结果 6例经手术病理证实 ,初诊多表现为急腹症 ,症状和体征不相符 ,5例误诊 ,1例术前确诊 ,2例肠系膜血管供血不足经CT及腹腔动脉造影明确诊断并经药物治疗 ,7例治愈 ,1例死亡。结论 该病较少见 ,症状和体征无特异性 ,难以做出准确的诊断 ,B超和CT是较敏感的检查 ,对诊断有积极的作用。早期切除坏死肠段 ,包括静脉阻塞的肠系膜部分 ,术中和术后抗凝治疗是预防复发、降低病死率的重要措施。

Objective In order to recognize the high risk of acute abdomen caused by mesenteric vascular lesions and to improve the treatment.Method 8 cases have been followed and analyzed in clinic features,curative methods and effects.Results 6 patients were operated on and the diagnosis was confirmed pathologically.Most of patients suffered the acute abdominal,pain and signs were in the disorder.5 patients misdiagnosed, 1 diagnosed preoperatively, 2 cases with mesenteric vascular insufficiency were diagnosed by CT, celiac arteriography and cured with drugs,7 cured, 1 died.Conclusions Mesenteric vascular diseases are uncommon,accurate diagnosis should not rely on symptoms and signs which were nonspecific.Ultrasonography,CT were the sensitive examinations and benefitted to diagnosis.Early operation for the resection of bowel gangrene involving their mesentery,early application of anticoagulant therapy is essential to reduce the mortality and recurrence.