导管接触性溶栓在急性肠系膜上动脉栓塞早期治疗中的应用价值

Catheter directed thrombolysis in the treatment of early acute superior mesenteric artery embolization

目的探讨导管接触性溶栓在肠系膜上动脉栓塞早期治疗中的应用价值。方法回顾性分析2015年8月至2020年7月期间,山东第一医科大学第一附属医院采用导管接触性溶栓治疗的19例急性肠系膜上动脉栓塞患者的临床资料。结果19例患者溶栓治疗成功15例,血流及肠道功能均恢复。4例患者溶栓治疗期间病情加重,其中3例剖腹探查证实发展为肠坏死,行肠切除术后恢复良好,1例死亡。结论对于尚未发生肠坏死的急性肠系膜上动脉栓塞患者早期采用导管接触性溶栓治疗临床效果显著,能够有效减轻血栓负荷,挽救缺血肠管。

Objective To evaluate catheter directed thrombolysis in the treatment of early acute superior mesenteric artery embolization.Methods The clinical data of 19 cases of acute superior mesenteric artery embolization treated with catheter directed thrombolysis therapy in the First Affiliated Hospital of Shandong First Medical University from Aug 2015 to Jul 2020 was retrospectively analyzed.Results Fifteen cases were treated successfully with catheter directed thrombolysis,the blood flow and intestinal function restored significantly.The condition of 4 patients worsened during catheter directed thrombolysis therapy.Among them,three cases of intestinal necrosis were later confirmed by exploratory laparotomy and they recovered well after enterectomy.One elderly patient unsuitable for laparotomy died.Conclusion Catheter directed thrombolysis is effective in the treatment of acute superior mesenteric artery embolization in early stage without intestinal necrosis.