肠系膜上动脉综合征8例诊治分析

Diagnosis and treatment of superior mesenteric artery syndrome in 8 cases

目的：探讨肠系膜上动脉综合征（SMAS）的病因、诊断及治疗,提高对该疾病的认识。方法：对铜陵市人民医院2000年1月～2015年3月期间病历完整的8例SMAS患者行回顾性分析。结果：上消化道全程造影、腹部CT检查及CT三维重建成像提示：十二指肠水平部受压梗阻、近端肠管扩张、腹主动脉和肠系膜上动脉的夹角与距离均减少。8例都经保守治疗,3例保守治疗无效后手术治疗,均恢复良好。7例患者随访4～122个月,体质量均增加,无复发及其他并发症,1例患者失访。结论：消瘦引起肠系膜上动脉-腹主动脉夹角狭窄是SMAS常见病因之一;诊断依赖于上消化道造影和腹部CT检查;治疗上首选保守治疗,必要时可采用手术治疗。

Objective：To investigate the etiology,diagnosis and treatment of superior mesenteric artery syndrome（SMAS）for better understanding of this disease.Methods：Retrospective analysis was performed in 8 cases of SMAS treated in our hospital during January 2000 and March 2015.Results：Radiography,including full gastrointestinal contrast,abdominal CT scan and tomographic reconstruction in three dimensional manner,indicated that SMAS was generally complicated with that compressive obstruction at duodenal level,distention at the proximal intestinal canal,reduced angle and distance between the abdominal aorta and superior mesenteric artery.Three cases in 8 undergone conservative treatment were surgically treated due to failure,and well recovered.Seven cases were followed from 4 to 22 months,which showed weight gain and no complications.Another one case was lost of follow-up.Conclusion：Narrowed superior aortomesenteric angle and aortomesenteric distance because of emaciation is one of the attributable factors to SMAS.Diagnosis of it primarily relies on CT angiography of the upper gastrointestinal tract and abdominal CT scans.Conservative treatment is preferred,and if necessary,surgical intervention is optional.