急性肠系膜血管缺血性疾病的诊断及治疗  

Diagnosis and Management of Acute Mesenteric Ischemia

作　　者：黄开红[1] 刘建化[1] 李学先[1] 陈其奎[1] 朱兆华[1] 陈亚进[1] 区庆嘉[1] 

机构地区：[1]中山大学附属第二医院,510120

出　　处：《岭南急诊医学杂志》2007年第5期338-339,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨急性肠系膜血管缺血性疾病(AMI)的诊断及治疗方法。方法:回顾性分析1986年1月至2006年1月本院收治的AMI患者28例的临床资料。结果:28例患者中男16例,女12例;平均年龄>40岁。有21例表现为腹痛、腹胀、恶心、呕吐、便血等。彩色多普勒超声检出率为81%;腹部CT/MR的检出率为100%。抗凝、溶栓及对症等非手术治疗的治愈率为81%;手术治疗12例的术后并发症为25%(3/12例),其中顽固性腹水2例,进食后腹痛1例。住院期间死亡3例,死因为感染性休克和多脏器功能衰竭。结论:腹部CT/MR对早期诊断AMI有重要意义,早期切除坏死肠管及术后使用抗凝剂在减少死亡率及复发中起重要作用。Objective： To explore the diagnosis and management of acute mesenteric ischemia （AMI）. Methods： Clinical data of 28 patients with AMI from Jan. 1986 to Jan. 2006 were analyzed retrospectively. Results： There were 16 males and 12 females with a mean age of over 40 years. Of them, 21 patients presented acute AMI. The main symptoms included abdominal pain and distention, nausea, vomiting, and bloody stool. The detectable rates of transabdominal color Doppler ultrasonography and CT/MR for AMI were 81% and 100% respectively. 13 of 16（81%） patients were cured with non-surgical management. 12 patients underwent surgical treatments, the postoperative morbidity rate was 25%, including ascites in 2 patients and postprandial abdominal pain in other 1 patient. 3 in-hospital patients died due to multi-organ failure or septic shock. Conclusions： Abdomen CT/MR are effective examinations for the diagnosis of AMI. Early resection of necrotic bowel and application of anticoagulant postoperatively are essential to reduce the mortality and recurrence of AMI.

关 键 词：急性肠系膜缺血性疾病 诊断 治疗 

分 类 号：R572.3[医药卫生—消化系统]