自发性孤立性肠系膜上动脉夹层的治疗现状  

Present situation in the treatment of spontaneous isolated superior mesenteric artery dissection

作　　者：李孝成(综述)[1] 刘佳(审校) LI Xiao-cheng;LIU Jia(Department of Vascular Surgery,the People's Hospital of Liuzhou City,Liuzhou 545001,Guangxi,CHINA)

机构地区：[1]广西柳州市人民医院血管外科,广西柳州545001

出　　处：《海南医学》2022年第7期935-938,共4页Hainan Medical Journal

基　　金：广西柳州市科技计划项目(编号:2019BJ10617)。

摘　　要：自发性孤立性肠系膜上动脉夹层(SISMAD)临床上非常罕见,治疗方式包括内科保守治疗、腔内治疗和外科手术,三者虽然各有优缺点和不同的适应证,但互为补充,没有一种治疗方法能彻底取代另一种治疗方法。绝大部分患者通过内科保守治疗都可以取得良好的治疗效果。对保守治疗效果不佳或夹层进展迅速的患者,则推荐首选腔内治疗。对于腔内治疗失败并有小肠缺血坏死或夹层破裂的患者,才选择采用开放外科手术。临床医师应针对患者的具体病情选择合理的个体化治疗方法,以尽最大可能改善患者的预后。Spontaneous isolated superior mesenteric artery dissection(SISMAD)is very rare clinically.The therapeutic means now employed in clinical practice include conservative management,endovascular treatment,and surgery.Although the three have their own advantages and disadvantages and different indications,they complement each other.Most patients can achieve good therapeutic effect by conservative treatment.For patients with poor treatment effect or rapid dissection progress,endovascular repair is recommended.Surgery is only used for patients with endovascular repair failure or intestinal necrosis or dissection rupture.The physicians should formulate a reasonable and individualized treatment strategy for each patient according to the specific condition of patients,so as to improve the prognosis of patients as much as possible.

关 键 词：肠系膜上动脉 夹层 治疗 药物治疗 外科手术 腔内治疗 

分 类 号：R543.5[医药卫生—心血管疾病]