阶梯式治疗方案治疗老年肠系膜上动脉血栓形成的临床研究  

Stepwise Treatment Regimen for Older Patients with Superior Mesenteric Artery Thrombosis

作　　者：张艳华 张珂 张海霞 文静 靳桂芳 李代京 郑新媚 常敏 王宏宇 Zhang Yanhua;Zhang Ke;Zhang Haixia;Wen Jing;Jin Guifang;Li Daijing;Zheng Xinmei;Chang min;Wang Hongyu(Department of Surgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of General Surgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Nursing,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Neurosurgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Orthopedics,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Intensive Care Unit,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院外科,中国北京100015 [2]首都医科大学附属北京地坛医院普外科,中国北京100015 [3]首都医科大学附属北京地坛医院护理部,中国北京100015 [4]首都医科大学附属北京地坛医院神经外科,中国北京100015 [5]首都医科大学附属北京地坛医院骨科,中国北京100015 [6]首都医科大学附属北京地坛医院ICU,中国北京100015

出　　处：《国际老年医学杂志》2020年第5期301-304,共4页International Journal of Geriatrics

摘　　要：目的探究阶梯式治疗方案治疗老年肠系膜上动脉血栓形成的效果及对院内死亡风险的影响。方法选取2012年2月~2018年12月首都医科大学附属北京地坛医院收治的老年肠系膜上动脉血栓形成患者96例作为研究对象,通过随机抽签法将其等分成干预组与对照组。对照组采用常规抗凝、溶栓治疗,干预组则予以阶梯式治疗。对比两组患者在肠系膜上动脉再通率,不良反应发生情况,治疗前后血浆同型半胱氨酸(Hcy)、叶酸(FA)水平,院内死亡发生情况等方面的差异。结果干预组肠系膜上动脉再通率高于对照组(P<0.05)。干预组与对照组在脓毒症、出血、水电酸碱紊乱、肠瘘发生率方面比较差异均无统计学意义(P>0.05)。治疗后干预组血浆Hcy水平低于对照组,而FA水平高于对照组(P<0.001)。干预组院内死亡率低于对照组(P<0.05)。结论阶梯式治疗方案治疗老年肠系膜上动脉血栓形成患者的效果显著,有效改善血浆Hcy、FA水平,同时有利于降低患者院内死亡风险。具有较高的临床推广应用价值。Objective To explore the effect of stepwise treatment on superior mesenteric artery thrombosis and its impact on the risk of in-hospital death of older patients.Methods A total of 96 older patients with superior mesenteric artery thrombosis admitted to Beijing Ditan Hospital of Capital Medical University were selected from February 2012 to December 2018.The patients were randomly divided into the intervention group and the control group.The control group was treated with conventional anticoagulation and thrombolysis.The intervention group was treated with stepwise treatment.The rate of superior mesenteric artery recanalization,the incidence of adverse reactions,the level of plasma homocysteine(Hcy)and folic acid(FA)before and after treatment,and the incidence of in-hospital death were compared between the two groups.Results The rate of superior mesenteric artery recanalization in the intervention group was higher than that in the control group(P<0.05).There were no significant differences between the two groups in the incidence of sepsis,hemorrhage,disorder of water,electrolyte,acid and alkali,and intestinal fistula(P>0.05).After treatment,plasma Hcy level was lower,while FA level was higher in the intervention group than those in the control group(P<0.05).The incidence of in-hospital death in the intervention group was lower than that in the control group(P<0.05).Conclusion The stepwise treatment has a significant effect on superior mesenteric artery thrombosis,which might effectively improve the levels of plasma Hcy and FA and reduce the risk of in-hospital death.

关 键 词：肠系膜上动脉血栓形成 阶梯式治疗 老年 院内死亡风险 

分 类 号：R543.5[医药卫生—心血管疾病]