急性肠系膜血管闭塞的诊治分析  

Diagnosis and treatment of acute mesenteric vascular occlusion

作　　者：谢菁[1] 龙景培[1] 胡铭荣[1] 季巧金[1] 王雄[1] 何桦波[1] 

机构地区：[1]杭州市第二人民医院外科,310015

出　　处：《中国医师进修杂志（外科版）》2007年第5期27-29,39,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 总结急性肠系膜血管闭塞（AMVO）的诊断与治疗。方法 对1989年5月-2005年5月收治的11例AMVO患者的诊治资料进行回顾性分析。肠系膜上动脉栓塞（MAE）5例，肠系膜上动脉血栓形成（MAT）3例，肠系膜上静脉血栓形成（MVT）2例，非阻塞性肠系膜血管供血不全（NOMI）1例。10例手术，其中坏死肠管切除一期吻合6例，二期吻合3例，1例保守治疗。所有病例均经抗凝、祛聚、扩血管治疗。结果 11例患者最终治愈6例，死亡5例，其中2例死于中毒性休克及多器官功能衰竭，2例死于再发梗死，1例死于短肠综合征，病死率为45．5％。结论 AMVO发病急，进展快，早期易误诊，后期病情凶险，早发现、早治疗及选择合理治疗方案是保证疗效的关键。Objective To explore the diagnosis and treatment of acute mesenteric vascular occlusion（AMVO）. Methods From May 1989 to May 2005, clinical data of 11 patients with AMVO were analyzed retrospectively. Five superior mesenteric arterial embolism （ MAE）, 3 superior mesenteric arterial thrombosis （ MAT）, 2 superior mesenteric venous thrombosis （MVT） and 1 nonocclusive mesenteric ischemia （NOMI） were included. The age of the patients were from 56 to 84 years old. The illness history were from 4 hours to 5 days. The abdominal pain was the main and common manifestation. Anticoagulants, thrombolytic and expanding blood vessel therapy were dehvered to patients after diagnosis. Ten patients were operated by intestinal canal and mesenteric excision according to the extent of necrotic gut, 1 was treated with conservative management. Results In 11 cases, 6 were cured, 5 were died after operation because of toxic shock and multiple organ failure （2 cases）, infarction recrudescence （2 cases） and short bowel syndrome （ 1 case）. The mortality was 45.5%. Conclusions AMVO is a severe and life threatening disease, early diagnosis and appropriate treatment timely are the keys to management of the disease.

关 键 词：急性肠系膜血管闭塞 血栓形成 诊断 治疗 

分 类 号：R572.3[医药卫生—消化系统]