急性肠系膜血管缺血性疾病误诊分析  

The analysis of misdiagnosis in the acute mesenteric ischemia disease

作　　者：吕国庆[1] 刘秉义[1] 张英[1] 

机构地区：[1]白求恩医科大学第三临床学院基本外科,长春130031

出　　处：《中国胃肠外科杂志》2000年第1期47-49,共3页

摘　　要：目的　探讨急性肠系膜血管缺血性疾病的误诊原因、诊断和治疗。方法回顾性分析１９６５～１９９９年急性肠系膜血管缺血性疾病２０例临床资料。结果２０例均经病理证实。初诊时多因表现为急腹症、症状与体症不符和缺乏特异性检查而误诊。１９例行手术治疗，其中１１例治愈， ８例死亡；另１例因误诊时间过长，未能及时手术，终导致死亡。结论该病少见，症状和体征无特异性，易造成误诊。选择性动脉造影和Ｄ－二聚体检测是较敏感的检查，对诊断有积极作用。早期适当范围切除坏死肠段和术后抗凝治疗是防止复发、降低病死率的重要措施。Objective To explore the reasons of misdiagnosis and the methods of diagnosis and treatment in acute mesenteric ischemia disease. Methods Twenty cases with acute mesenteric schema disease from 1965 to 1999 were analyzed retrospectively. Results The diagnosis of all cases was confirmed pathologically. The most patients were misdiagnosed because they suffered the acute abdominal pain and their symptoms were not in accordance with their signs, and also because there was a lack of specific examination. Nineteen patients received operation and 11 cured, 8 died. One patient died because of a too long period of misdiagnosis and without an operation in time. Conclusion (1) Acute mesenteric ischemia disease is an uncommon disease, its nonspecific symptoms and signs lead to a misdiagnosis easily. Selective angiography and D-dimer detection were sensitive. (2)Early resection of necrotic bowel and early application of anticoagulant therapy are essential to reduce the mortality and recurrence.

关 键 词：急性 肠系膜血管缺血 误诊 动脉造影 

分 类 号：R656.7[医药卫生—外科学]