介入治疗肠系膜上动脉缺血性疾病的疗效评价  

Clinical Evaluation of Interventional Therapy for Superior Mesenteric Artery Ischemia

作　　者：梁松年[1] 夏永辉[1] 张曦彤[1] 钟红珊[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《中国医科大学学报》2013年第3期271-273,285,共4页Journal of China Medical University

基　　金：国家自然科学基金资助项目(81171443/H1816)

摘　　要：目的评价经导管溶栓及支架植入术治疗肠系膜上动脉（SMA）缺血性疾病的有效性及安全性。方法回顾性分析26例SMA缺血并接受介入治疗病例。其中，粥样硬化所致SMA狭窄14例，夹层所致狭窄4例，栓塞和（或）血栓形成8例。所有患者先行SMA造影，判定病变性质、范围、程度，再进一步置管溶栓和（或）支架植入治疗。术后观察症状改善程度，必要时行外科处理。结果26例患者均完成介入治疗，18例患者术中植入1枚支架，8例患者行置管溶栓治疗，其中2例溶栓后各植入1枚支架。术后24h内所有病例腹痛症状均逐渐缓解，无手术相关并发症发生。随访7～18个月（平均13．5个月），1例患者术后8个月腹痛复发，行置管溶栓及球囊扩张治疗后症状消失。结论介入治疗作为一项微创技术，是SMA缺血性疾病安全有效的治疗手段。Objective To evaluate the clinical efficacy and safety of catheter-directed thrombelysis and stentt implantation in patients with superior mesenteric artery （SMA） ischemia. Methods The clinical data of 26 superior mesenteric artery ischemia patients who accepted in- terventional therapy were analyzed retrospectively. SMA ischemia was caused by atherosclcrosis in 14 cases,by dissection in 4 cases,and by embolism and （or） thrombosis in the other 8 patients. Angiography was fnst applied in all patients to assess the character, extent and degree of ischemia before catheter-directed thrombolysis and （or） stent implantation. Surgical process was performed if the symptom was aggravated after interventional therapy. Results All the 26 patients completed interventional therapy successfully. Eighteen patients accepted single stent implantation post-angiography, and the other 8 patients received catheter-directed thrombelysis including 2 cases of stent implantation af- ter thrombolysis. _Abdominal pain was gradually relieved within 24 h after treatment in all the patients without a complication. Mean follow-up was 13.5 months （7-18 months）. Abdominal pain recuned in one patient at 8 months post-treatment due to reocclusion of stentt arid vanished after catheter-directed thrombelysis and percutaneous tmnsluminal angioplasty. Conclusion As a minimally invasive technology, intervention- al therapy is a safe and effective method for SMA ischemia.

关 键 词：肠系膜上动脉 缺血 介入治疗 

分 类 号：R574[医药卫生—消化系统] R816.5[医药卫生—内科学]