Fogart导管辅助取栓术治疗急性肠系膜上动脉栓塞  

Treatment of Acute Superior Mesenteric Artery Embolism by Fogarty Catheter

作　　者：于福田[1] 李忠耀[1] 夏洪波[1] 马利[1] 刘也[1] 

机构地区：[1]黑龙江省鸡西矿业集团总医院,黑龙江鸡西158100

出　　处：《黑龙江医学》2011年第5期364-366,共3页Heilongjiang Medical Journal

摘　　要：目的急性肠系膜上动脉栓塞(mesenteric artery embolis m,MAE),具有高致残率及致死率。早期的诊断和恰当的治疗是降低致残率及致死率最重要的因素。方法对2002-09～2010-07间,收治的8例急性肠系膜上动脉栓塞的患者行Fogarty导管辅助取栓治疗,早期的6例病人经取栓后给予抗凝、溶栓治疗;晚期的2例合并有肠坏死的病人行Fogarty导管辅助取栓后,行坏死肠管切除吻合,术后酌情抗凝、溶栓治疗。结果早期诊断的6例病人经Fogarty导管辅助取栓治疗均获治愈,无肠坏死,晚期的2例病人行Fogarty导管辅助取栓后,行部分肠切除术,其中1例术后3 d死亡。结论建议对突然出现腹痛、恶心、呕吐,白细胞升高合并酸中毒,尤其是有心脏瓣膜病和房颤的病人,均应早期行肠系膜血管彩超或腹腔血管增强CT扫描检查,以早期明确诊断。对诊断明确的病人应立即行Fogarty导管辅助取栓术,并同时配合溶栓和抗凝治疗。Objective Acute mesenteric artery embolism has a high rate of morbidity and mortality.Early diagnosis and appropriate treatment are the most important factors associated with morbidity and mortality.Methods 8 patients who underwent superior mesenteric artery embolectomy by Fogarty cathetern,from 2002 to 2010,were analyzed.6 cases were performed by Fogarty catheter and no bowel resection was necessary.2 patients with late intestinal necrosis of patients undergoing assisted Fogarty embolectomy catheter underwent necrotic bowel resection andanastomosis.Appropriate anticoagulation and thrombolytic therapy were performed post operation.Results 6 casesof early diagnosis of patients assisted by Fogarty embolectomy catheter treatment were cured,and no intestinal necrosis.2 patients underwent late Fogarty embolectomy catheter underwent auxiliary partial bowel resection,1 casedied 3 d after surgery.Conclusion We suggest that ultrasonography and computed tomography should be done inpatients with sudden abdominal pain,nausea,vomiting,mild leukocytosis,and metabolic acidosis who have previous valvular heart disease or atrial fibrillation.All patients who wre confirmed Acute mesenteric artery embolismshould be under-went a operation which embolectomy was done by Fogarty catheter.Patients who have the cleardiagnosis should immediately perform Fogarty embolectomy catheter and also assisted with thrombolysis and anticoagulation therapy.

关 键 词：肠系膜上动脉 血栓栓塞 FOGARTY导管 

分 类 号：R619.2[医药卫生—外科学]