肠系膜上动脉压迫综合征的腹腔镜手术治疗  

Laparoscopic surgery on superior mesenteric artery compressing syndrome

作　　者：张豫峰[1] 刘成远 郭永强[1] 梁若鹏[1] 陈壬寅[2] 

机构地区：[1]郑州大学第一附属医院腹腔镜外科,450052 [2]郑州大学第一附属医院病理科,450052 [3]商丘市第一人民医院腹腔镜外科

出　　处：《中华普通外科杂志》2017年第9期763-765,共3页Chinese Journal of General Surgery

基　　金：河南省科技发展计划资助项目（162102310188）;河南省医学科技攻关计划资助项目（201503028）;河南省教育厅资助项目（142300410208）

摘　　要：目的探讨肠系膜上动脉压迫综合征的诊断和腹腔镜手术治疗。方法回顾性分析郑州大学第一附属医院2006年10月至2016年5月行完全腹腔镜手术治疗62例肠系膜上动脉压迫综合征患者的临床资料、治疗和随访结果。结果本组患者行上消化道造影检查62例，确诊59例；CT血管造影检查44例，确诊31例；彩超检查26例，确诊19例。采取完全腹腔镜十二指肠空肠吻合术41例，完全腹腔镜胃肠吻合14例。完全腹腔镜胃十二指肠双捷径吻合术7例，患者均缓解或痊愈出院，手术疗效满意。结论肠系膜上动脉压迫综合征首选辅助诊断方法是上消化道X线造影，彩超或CT血管造影测量腹主动脉与肠系膜上动脉夹角能提供参考：对于反复发作并且保守治疗效果不佳的患者应手术治疗．以完全腹腔镜十二指肠空肠吻合术为主要术式。Objective To discuss the diagnosis and laparoscopic treatment for superior mesenteric artery compressing syndrome （SMACS）. Methods A retrospective analysis was conducted on 62 SMACS patients who had received total laparoscopy treatment from October 2006 to May 2016. Results All 62 cases received upper gastrointestinal series and definite diagnosis was achieved on 51 cases; Definite diagnosis was made on 31 cases among 44 cases undergoing CTA （ CTA, CT angiography） examination, 19 cases were diagnosed with the disease among 26 cases who had received ultrasound examination. Total laparoscopic duodenojejunostomy was conducted on 41 cases, total laparoscopic gastrointestinal anastomosis was conducted on 14 cases, total laparoscopic gastroduodenal double shortcut anastomosis was conducted on 7 cases. All patients were cured or alleviated and discharged from hospital. Conclusions Upper GI contrast series made definite diagnosis on most SMACS cases, For patients with relapsing symptoms and poor conservative treatment result a surgery is recommended. Total laparoscopic duodenojejunostomy is the mainstay of treatment and is safe and reliable.

关 键 词：上肠系膜动脉综合征 吻合术 外科 腹腔镜 

分 类 号：R657.2[医药卫生—外科学]