急性肠系膜血管供血不全18例临床分析  

Diagnosis and treatment of acute blood-supply inadequacy of mesenteric vessel in eighteen cases

作　　者：叶伟坤[1] 曾沛强[1] 蔡光友[1] 

机构地区：[1]广东省东莞市人民医院,529000

出　　处：《山西医药杂志》2005年第2期109-110,共2页Shanxi Medical Journal

摘　　要：目的　探讨急性肠系膜血管供血不全的围手术期处理经验 ,提高对该病的诊治水平。方法　回顾性分析 18例急性肠系膜血管供血不全的临床资料。结果　发病时间为 17h～ 14d ,腹痛为主要表现。 17例均在全身麻醉下行急诊剖腹探查手术 ,根据术中所见行坏死肠管及肠系膜切除、肠吻合术。手术患者经病理证实肠系膜上动脉栓塞 10例 ,肠系膜上动脉血栓形成 5例 ,肠系膜上静脉血栓形成 2例。术后死亡 4例 ,其中中毒性休克 2例 ,肠吻合口瘘致腹腔感染 1例 ,弥漫性血管内凝血 (DIC) 1例。结论　外科手术是治疗本病的最终有效措施。围手术期的及时准确处理是手术成功的关键。Objective To investigate and summarize the diagnostic and surgical experiences of 18 cases with acute blood-supply inadequacy of mesenteric vessel so as to improve the technology of dealing with this severe disease.Methods There were 18 cases with acute blood-supply inadequacy of mesenteric vessel who were retrospectively analysed.Results The onset time of this disease was 17 h～14 d, and abdominal pain was the main and common manifestation. There were 17 cases who had timely operation of intestinal canal and mesenteric excision according to the extent of necrotic intestinal canal. It proved that there were 10 cases of superior mesenteric arterial embolus, 5 cases of superior mesenteric arterial thrombosis and 2 cases of superior mesenteric venous thrombosis. Four cases died after operation of toxic shock(2 cases), intestinal anastomotic fistula(1 cases) and disseminated intravascular coagulation (1 case).Conclusion Operation is the final-effective treatment for acute bloodsupply inadequacy of mesenteric vessel,and the key of operation is timely and accurate management of peri-operation.

关 键 词：急性肠系膜血管供血不全 治疗 肠系膜上动脉栓塞 术后死亡 肠系膜上静脉血栓形成 经病 手术成功 根据 目的 表现 

分 类 号：R657.2[医药卫生—外科学] R654.3[医药卫生—临床医学]