急性肠系膜上动脉缺血血管腔内治疗的临床经验

Clinical diagnosis and treatment experience of endovascular therapy on acute superior mesenteric artery ischemia

目的总结肠系膜上动脉缺血的血管腔内治疗治疗效果。方法 2015年5月~2016年6月,共7例患者术前采用CT血管成像检查诊断肠系膜动脉缺血,均优先采用血管腔内治疗的方式。结果一例患者因症状重,接诊时间超过24小时,腔内治疗后需要行部分小肠切除术;另有一例患者因溶栓过程出现腹膜后血肿,在保守治疗2月后,血肿明显缩小,肠系膜上动脉闭塞后侧支循环代偿,无需切除肠管;其余患者均由血管腔内治疗救治成功(71.42%),临床症状明显缓解,无患者死亡。结论及时应用血管腔内技术治疗肠系膜上动脉缺血能使患者在生存率及致残率上获益。

Objective To summarize the effect of endovascular therapy of acute superior mesenterie artery isehemia （ASMAI）. Methods From May 2015 to June 2016, 7 patients suffered from ASMAI diagnosed via CT angiography （CTA） , underwent endovascular therapy. Results One patient with severe symptoms for more than 24 hours needed to accept partial small bowel resection after endovascular therapy. Another one case accompanied with retroperitoneal hematoma during the endovascular thrombolytic therapy. However, after two months of conservative treatment, the retroperitoneal hematoma significantly was relieved, and the compensatory circulation occurred. And the rest of all the cases （71.42%） were successfully achieved via endovaseular therapy, whom presented with the clinical symptoms obviously alleviated, and no one died of the disease. Conclusion The timely application of endovascular technique in the treatment of ASMAI can be to the benefit of patients＇disability rate and morbidity.