肠系膜上动脉瘤的治疗策略  

Strategies for Managing Superior Mesenteric Artery Aneurysms

作　　者：孙晓宁[1] 郑月宏[1] SUN Xiao-ning;ZHENG Yue-hong(Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Acadamy of Medical Sciences &Peking Union Medical College, Beijing 100730, China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院血管外科,北京100730

出　　处：《协和医学杂志》2020年第5期537-541,共5页Medical Journal of Peking Union Medical College Hospital

基　　金：国家自然科学基金(81470586)。

摘　　要：肠系膜上动脉瘤(superior mesenteric artery aneurysm,SMAA)是一类罕见的血管疾病,其发生破裂、导致患者死亡的风险较高。SMAA的治疗手段包括手术治疗和保守观察。传统开放手术术式包括动脉瘤结扎、动脉瘤切除联合肠系膜上动脉重建/肠段部分切除。血管腔内治疗创伤较小,适用于合并症复杂的病例或分支动脉瘤。动脉瘤栓塞和腔内覆膜支架置入是常见的介入治疗方法。目前对于SMAA的报道和治疗经验相对缺乏,临床需在明确诊断的基础上,全面考虑SMAA的诱因、病理生理变化等因素,制定安全有效的治疗方案。本文梳理SMAA治疗策略,旨在为临床提供参考。Superior mesenteric artery aneurysm(SMAA)is a rare vascular disease entity with high risk of rupture and mortality.Patients are treated either with surgical intervention or conservative observation.Traditional open surgery includes simple ligation,aneurysmectomy with reconstruction of the mesenteric artery,and simultaneous bowel resection.Endovascular treatment is considered less invasive and preferred in patients with complex comorbidities or branch aneurysms.Embolization and endovascular stenting are the major choices of endovascular treatment.Given the knowledge on the management of SMAA is relatively limited,clinical decisions should be made with great caution,regarding the etiology,pathophysiology of SMAA,and the risk of perioperative and long-term complications.

关 键 词：肠系膜上动脉瘤 肠系膜动脉重建 腔内治疗 治疗策略 

分 类 号：R654.3[医药卫生—外科学] R657.2[医药卫生—临床医学]