肠系膜上动脉综合征57例临床分析  

An analysis of fifty-seven cases with superior mesenteric artery syndrome

作　　者：金辉[1] 崔永欣[1] JIN Hui CUI Yongxin.(Department of General Surgery, Zhoukou Center Hospital, Zhoukou 466000, CHIN)

机构地区：[1]周口市中心医院普通外科,河南省466000

出　　处：《江苏医药》2017年第1期17-19,F0003,共4页Jiangsu Medical Journal

摘　　要：目的总结肠系膜上动脉综合征(SMAS)的病因、诊断和治疗方法。方法回顾性分析57例经X射线钡餐造影、彩色多普勒超声(彩超)检查或手术确诊为SMAS患者的临床资料。结果 57例均先行保守治疗。其中的25例腹痛缓解,呕吐症状消失出院。另32例保守治疗无效而采用手术治疗:十二指肠空肠侧侧吻合术19例,Treitz韧带松解术6例,十二指肠空肠Roux-en-Y吻合术4例,远端胃大部分切除+胃空肠吻合术1例,胃空肠Roux-en-Y吻合术2例。30例术后痊愈出院。结论 SMAS无特异性症状,易漏诊、误诊。上消化道造影结合彩超可以提高诊断率。首选非手术治疗,无效者可采用针对性手术治疗。Objective To summarize the cause, diagnosis and treatment of superior mesenteric artery syndrome（SMAS）. Methods Clinical data of 57 patients with SMAS were retrospectively analyzed, which was diagnosed by the examinations of barium meal, color Doppler ultrasonography and surgery. Results The conservative treatment was performed at first in 57 patients, after which 25 cases were discharged when abdominal pain was attenuated and vomiting was disappeared. Another 32 cases were failed to the conservative treatment and surgeries were carried out thereafter. The surgeries were included side to side duodenojejunostomy in 19 cases, Treitz ligament release technique in 6 cases,Roux-en-Y anastomose in 4 cases, distal gastric resection and gastrojejunum anastomosis in one case, gastrojejunum Roux-en-Y anastomose in 2 cases. Thirty cases underwent surgical treatment were cured and discharged. Conclusion SMAS has no specific clinical symptoms and the diagnosis is easily missed and misdiagnosed. The diagnosis rate of SMAS may be improved by upper gastroenterography combined with colour ultrasonography examination. The conservative treatment for SMAS is the first choice and the targeted surgeries are needed in SMAS patients failed to the conservative treatment.

关 键 词：肠系膜 上动脉 综合征 

分 类 号：R657[医药卫生—外科学]