21例急性肠系膜动脉栓塞治疗体会

Experience in the Management of Acute Mesenteric Arterial Embolism: Report of 21 Cases

目的:总结急性肠系膜动脉栓塞的治疗经验。方法:对1990年～2001年收治的急性肠系膜动脉栓塞21例的临床资料进行回顾性分析。结果:21例患者中死亡4例,2例死于感染中毒性休克,2例死于多脏器功能衰竭。余17例顺利恢复,其中6例术后剩留小肠小于1米而出现短肠或超短肠综合征,经静脉营养与经口进食等综合治疗全部痊愈。本组随访12个月12例、24个月5例,均健在。结论:及时诊断和早期手术是提高治愈率的关键。尽可能保留有生机的肠段,对术后短肠和超短肠综合征,采取静脉营养和经口进食并举的综合治疗,可以较快地恢复肠管的消化吸收功能。

Objective:To summarize our experience in the management of acute mesenteric arterial embolism. Methods: Twenty one cases with acute mesenteric arterial embolism were treated from 1990 to 2001. Results: In this group, two patients died of septic shock and two died of MOF, while 6 developed short or ultra bowel syndrome,all the 17 cases were finally cured by means of combined intravenous nutrition and oral feeding. 17 patients were followed up for 12~24 months,all are in good health. Conclusions:Timely diagnosis and prompt operation are important to elevated survival rate. For patients with short or ultra short bowel syndrome, comprehensive measures of intravenous nutrition and stepwise oral feeding in combination can quickly restore digestive and absorptive function of the residual intestine.