DSA下杂交手术治疗肠系膜上动脉栓塞  

Hybrid Surgical Treatment under Digital Subtraction Angiograpy(DSA)for Acute Superior Mesenteric Artery Embolism

作　　者：王迪[1] 郎德海[1] 胡明[1] 胡松杰[1] 

机构地区：[1]宁波市第二医院血管外科,浙江宁波315010

出　　处：《中国现代医生》2011年第33期142-143,146,共3页China Modern Doctor

摘　　要：目的探讨及评价DSA下杂交手术治疗肠系膜上动脉栓塞的疗效及应用前景。方法 12例急性肠系膜上动脉(SMA)栓塞患者(房颤10例,高血压病1例,无伴随疾病1例),急诊CTA证实后DSA下杂交手术,包括①SMA导管溶栓、取栓;②SMA经皮球囊扩张成形及内支架置入;③SMA导管溶栓、取栓联合开腹手术。结果 12例患者均成功取出栓子,栓塞动脉再通,肠管血运可。其中①SMA导管溶栓、取栓6例;②PTA及内支架置入1例;③SMA导管溶栓、取栓联合开腹手术5例。10例患者治愈出院,2例术后24h死亡。结论 DSA下杂交手术治疗肠系膜上动脉栓塞是一种新型、综合的治疗方法,能融合各种手术方式的优点,克服其缺点。Objective To explore and evaluate the effect and application prospect of Hybrid surgical treatment under DSA for acute superior mesenteric artery （ SMA ） embolism. Methods Twelve cases （ atrial fibrillation in 10 cases;hypertension in lcase; no associated disease, 1 case ） of SMAE were treated with hybrid surgical operation under emergency DSA after CTA confirmed,including： ①SMA catheter thrombolysis, embolectomy; ②by the SMA balloon angioplasty and stent placement; ③ SMA catheter thrombolysis, thrombectomy combined laparotomy. Results Twelve patients were successfully removed emboli, embolism arterial recanalization, intestinM blood flow can be. Which ④SMA catheter thrombolysis, thrombectomy in 6 cases; ⑥ PTA and stent in 1 case;⑤SMA catheter thrombolysis, thrombectomy combined laparotomy in 5 cases. 10 patients were cured, 2 patients died after 24h. Conclusion Hybrid surgical operation under DSA for SMAE is a new, comprehensive treatment approach that can blend the advantages of a variety of surgical procedures to address its shortcomings.

关 键 词：肠系膜上动脉栓塞 介入 杂交手术 数字减影血管造影 

分 类 号：R657.2[医药卫生—外科学]