急性闭塞性肠系膜上动脉缺血的诊治分析(附9例报告)  

Diagnosis and treatment of acute superior mesenteric artery ischemia(with 9 cases report)

作　　者：马洺远[1] 林纲毅[1] 蔡宗洋 刘文亚 马创鑫 李思慎 Ma Mingyuan;Lin Gangyi;Cai Zongyang;Liu Wenya;Ma Chuangxin;Li Sishen(Department of Vascular Intervention,ShanTou Central Hospital,Shantou,Guangdong,515000,China)

机构地区：[1]汕头市中心医院血管介入科,广东汕头515000

出　　处：《当代医学》2020年第23期106-109,共4页Contemporary Medicine

摘　　要：目的探讨急性肠系膜上动脉缺血(acuteocclusive superior mesenteric artery ischemia,AOSMAI)的诊断与治疗,降低病死率。方法回顾性分析本院2014年1月至2019年10月收治的9例急性肠系膜上动脉缺血患者的临床资料。结果 9例均为急性腹痛就诊,其中3例伴有消化道出血,经CTA、血管造影确诊,8例行介入腔内治疗,1例肠系膜上动脉夹层行保守治疗,痊愈8例,死亡1例。结论对于腹痛剧烈而腹部体征轻微的患者,应警惕急性肠系膜上动脉缺血可能,CTA、血管造影检查有助于早期诊断,早诊断、早介入腔内治疗是改善预后的关键,夹层与血栓两者的治疗有区别,7F导引导管可作为肠系膜上动脉血栓抽栓的首选。Objective To investigate the diagnosis and treatment of acute superior mesenteric artery ischemia, aimed to reduce the mortality.Methods The clinical data of 9 cases of acute mesenteric artery ischemia in our hospital were retrospectively analyzed from January 2014 to October 2019. Results 9 cases patient were administered for acute abdominal pain, of which 3 were accompanied by gastrointestinal bleeding. All cases wereconfirmed diagnosis by CTA and angiography. 8 cases were treated with interventional treatment, 1 case with superior mesenteric aortic aneurysm was treated conservatively, and 8 patients were cured while 1 patient died. Conclusion In cases of severe abdominal pain and mild abdominal signs, we should be alert to the possibility of acute upper mesenteric artery ischemia. CTA and angiography examination are useful for early diagnosis. Early diagnosis and early interventional treatment are the key to favored prognosis. The treatments of mezzanine and thrombus differ, and the 7 F guide tube can be used as the first choice for superior mesenteric arterial thrombus.

关 键 词：急性肠系膜上动脉缺血 介入腔内治疗 夹层 栓塞 

分 类 号：R572.3[医药卫生—消化系统]