急性肠系膜上动脉栓塞24例临床分析  

Clinical analysis of 24 cases with superior mesenteric artery embolism

作　　者：赵鑫[1] 李德春[1] 王毅[1] 李智[2] 刘永浩[3] 

机构地区：[1]苏州大学附属第一医院普通外科,215006 [2]苏州大学附属第一医院介入科,215006 [3]苏州大学附属第一医院放射科,215006

出　　处：《江苏医药》2010年第24期2912-2914,共3页Jiangsu Medical Journal

摘　　要：目的探讨急性肠系膜上动脉栓塞(SMAE)早期诊断要点及取栓的临床疗效。方法回顾性分析24例SMAE患者的临床资料。根据从发病到手术的时间分为两组:A组7例,发病后8 h内行手术者;B组17例,发病8 h后行手术者。均行取栓术,术中在动脉内灌注尿激酶,术后应用肝素抗凝。根据肠管是否发生坏死,行或不行肠管部分切除。结果 A组取栓术后,4例小肠血运恢复正常,3例行肠切除;B组17例均行肠切除,其中12例为长段肠管切除。A组肠坏死率为42.9%,B组为100%;A组病死率为0,B组为41.2%(P<0.05)。结论早期诊断和及时治疗SMAE有助于降低肠坏死率及病死率。Objective：To investigate the outcomes of early diagnosis and treatment of superior mesenteric artery embolism（SMAE）.Methods：The clinical data of 24 patients with SMAE were retrospectively analyzed.The patients were divided into two groups of A（7 cases,operated within 8 hours after onset of symptoms） and B（17 cases,operated 8 hours after onset）.All patients underwent embolectomy,urokinase administration directly into the superior mesenteric artery during operation,and heparin anticoagalation after operation.On the basis of circulation of the involved intestine,segmental intestinal resection was performed.Results：After embolectomy,circulation of the intestine recovered in 4 cases and segmental intestinal resection was performed in 3 cases in group A.Intestinal resection had been caried out in 17 patients in group B,in whom extended intestinal resection was performed in 12 patients.The intestine necrosis rate was lower in group A than that in group B（42.9% vs.100%）（P0.05）.So did the motality（0 vs.41.2%）（P0.05）.Conclusion：Early diagnosis and treatment in time can reduce the incidence of bowel necrosis rate and mortality in the patients with acute SMAE.

关 键 词：肠系膜上动脉栓塞 

分 类 号：R657[医药卫生—外科学]