肠系膜上动脉血栓栓塞的早期影像学诊断及介入治疗  

Early imaging diagnosis and interventional treatment of superior mesenteric artery thromboembolism

作　　者：朱西琪 吕健[1] 蒋洪春[1] 林薇[1] 张建梅[1] Zhu Xiqi;Lyu Jian;Jiang Hongchun;Lin Wei;Zhang Jianmei(Department of Medical Imaging,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Guilin 541001,China)

机构地区：[1]广西壮族自治区南溪山医院医学影像科

出　　处：《中国临床保健杂志》2019年第4期477-479,共3页Chinese Journal of Clinical Healthcare

基　　金：广西壮族自治区桂林市科学研究与技术开发计划资助项目(20120121-4-2)

摘　　要：目的 评价肠系膜上动脉(SMA)血栓栓塞的早期影像学诊断及介入治疗的应用价值。方法 选取SMA血栓栓塞患者72例为研究对象,按照随机数字表法分为两组,研究组使用介入疗法,对照组使用保守疗法,记录两组治疗有效率,随访1个月对死亡率和疾病复发率进行记录,评价治疗安全性。结果 对72例患者进行血管造影,发现主干动脉、回肠动脉、空肠动脉、肝动脉胃十二指肠动脉栓塞的例数分别为53例(73.61%)、6例(8.33%)、9例(12.50%)、4例(5.55%),充盈缺损长度为4.3~9.7cm,无肠坏死,50例(69.44%)肠腔积液、积气,9例(12.50%)显示出现内膜片;研究组治愈、无效分别为30例(83.33%)、2例(5.56%),总有效率为94.44%,对照组总有效率仅为77.78%,差异有统计学意义(P<0.05);研究组、对照组安全性事件发生率分别为1例(2.77%)、4例(11.11%),其中研究组没有死亡患者,复发率为1例(2.77%),对照组有1例(2.77%)死亡,复发率为3例(8.33%)。结论 血管造影联合介入治疗用于急性SMA血栓栓塞患者早期诊断和治疗的有效率、安全性较高。Objective To evaluate the clinical value of early imaging diagnosis and interventional onearly mesenteric artery (SMA) thromboembolism. Methods Seventy-two patients with SMA thromboembolism were enrolled in the study.They were randomly divided into two groups.The study group used interventional therapy and the control group used conservative therapy to record the effectiveness of the two groups.Mortality and disease recurrence rates were recorded one month to assess treatment safety. Results The angiographic findings of 72 patients were as follows:53 cases (73.61%),6 cases (8.33%),9 cases (12.50%) and 4 cases (5.55%) were embolized by main artery,ileal artery,jejunal artery and hepatic artery.The length of filling defect was (4.3-9.7) cm,without intestinal necrosis,50 cases (69.44%) had hydrocele and pneumocele,and 9 cases (12.50%) showed intimal film.There were 30 cases (83.33%) cured and 2 cases (5.56%) ineffective in the study group,and the total effective rate was 94.44%.The total effective rate in the control group was only 77.78%.The difference was statistically significant ( P <0.05).The incidence of safety incidents in the study group and the control group was 1 case (2.77%) and 4 cases (11.11%).There were no death in the study group and the recurrence rate was 1 case (2.77%).1 case died (2.77%) and the recurrence rate was 3 cases (8.33%) in the control group. Conclusion Interventional therapy combined with angiography for the treatment of acute SMA thromboembolism is safe and effective.

关 键 词：血栓栓塞 肠系膜血管闭塞 血管造影术 

分 类 号：R572.3[医药卫生—消化系统]