急性肠系膜血管缺血早期确定性手术后病人的营养支持  

Nutritional support after early definitive operation in acute mesenteric ischemia

作　　者：王凯[1] 李幼生[1] 王剑[1] 郭明晓[1] 范磊[1] 李元新[1] 黎介寿[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2011年第2期75-78,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨急性肠系膜血管缺血(AMI)早期确定性手术治疗后营养支持的方法和应用价值。方法:回顾性分析我科收治的9例AMI病人的临床资料。分别诊断为肠系膜上动脉栓塞1例,肠系膜上静脉血栓6例,非闭塞性肠系膜缺血2例。9例病人均急诊手术,并于术后早期给予营养支持治疗,其中7例联合溶栓治疗。结果:9例病人均顺利完成早期确定性手术,其中4例吻合口瘘病人均经保守治疗痊愈。术后(3.67±3.35)d行肠外营养(PN)治疗,持续(14.44±15.33)d,术后(8.11±6.17)d行肠内营养(EN)治疗,持续(13.67±10.62)d,肠功能基本恢复正常出院。随访6个月9,例病人均逐渐摆脱营养支持恢复经口饮食,体重和营养状况较前改善。结论:早期确定性手术和营养支持治疗能提高AMI病人的治愈率,改善病人的营养状况,临床效果好。Objective： To explore the method and value of nutritional support in acute mesenteric ischemia（AMI） after early definitive operation.Methods： The clinic data of 9 patients with AMI admitted between Jan.2008 and Sep.2009 were analyzed retrospectively.9 patients were diagnosed as superior mesenteric artery embolism（1 case）,superior mesenteric vein thrombosis（6 cases）,nonocclusive mesenteric ischemia（2 cases）.All got emergency operation and early nutritional support,and 7 patients were associated with thrombolysis.Results： 9 patients received early definitive operation successfully.Fistula of anastomotic stoma appeared in 4 cases postoperatively and all recovered from fistula.PN was performed and EN followed.All cases were discharged after the function of intestine was recovered.The follow-up period was 6 months.Overall,9 patients got rid off nutrition support gradually.Nutritional status was improved significantly with positive symptomatic treatment.Conclusion： From our experience,early definitive operation and nutritioal support may have a positive effect on the prognosis in AMI patients.

关 键 词：急性肠系膜缺血 营养支持 早期确定性手术 

分 类 号：R657.2[医药卫生—外科学]