急性肠系膜血管性疾病的诊治  

Diagnosis and treatment of acute mesenteric vascular diseases

作　　者：邱昌城 李光新[2] 王宾[2] 王坤[2] 王辉[2] 史作磊[2] 于剑 Qiu Changcheng1, Li Guangxin2 ,Wang Bin2, Wang Kun2 ,Wang Hui2 ,Shi Zuolei2, Yu Jian2(1 Department of General Surgery, Gaomi City People＇s Hospital, Gaomi 261500, Shandong China; 2 Department of Vascular Surgery, Qianfoshan Hospital of Shandong Province, Jinan 250014, Chin)

机构地区：[1]山东省高密市人民医院普外二科,山东高密261500 [2]山东省千佛山医院血管外二科,济南250014

出　　处：《血管与腔内血管外科杂志》2017年第5期937-939,共3页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨肠系膜血管疾病所致急腹症的早期诊断及处理方法。方法对2015年8月至2017年8月山东省千佛山医院血管外科收治的收治11例急性肠系膜血管疾病患者的临床资料进行回顾性分析。结果 11例患者中肠系膜上动脉栓塞6例,肠系膜上静脉血栓形成3例,肠系膜上动脉夹层1例,肠系膜上动脉粥样硬化并血栓形成1例。其中有5例行剖腹探查证实肠坏死,行坏死肠段切除术,4例行介入治疗,效果满意,2例选择保守治疗,总体效果欠佳。2例患者发病1个月内因肠坏死、腹腔感染、合并其他脏器功能衰竭等原有疾病死亡;1例并发短肠综合征。结论肠系膜血管疾病起病急,发展迅速,较短时间即可发生肠坏死,预后极差,而早期诊断是提高早期治疗的关键。Objective To explore the early diagnosis and treatment of acute abdominal disease caused by mesenteric vascular disease. Methods Clinical data of 11 patients with acute mesenteric vascular disease in Qianfoshan hospital of shandong province from August 2015 to August 2017 were retrospectively analyzed. Results In 11 cases, 6 cases of mesenteric artery embolization were found in the mesenteric mesenteric artery, 3 cases of venous thrombosis were formed in the mesenteric mesenteric, 1 case of the mesenteric artery, and 1 case of atherosclerosis and thrombosis. There were 5 cases chose laparotomy to confirm intestinal necrosis and necrotic enterectomy, 4 cases chose interventional therapy and curative effect were satisfactory, the rest of two patients chose conservative treatment, and the overall effect was not good. In 2 cases, the patient died within 1 month due to intestinal necrosis, abdominal infection, and other organ failure, One case of concurrent short bowel syndrome. Conclusion Mesenteric vascular disease is acute and developing rapidly, intestinal necrosis can occur in short time, and the prognosis is very poor, and early diagnosis is the key to early treatment.

关 键 词：肠系膜血管疾病 血管栓塞 血栓形成 早期诊断 

分 类 号：R572.3[医药卫生—消化系统]