中西医结合治疗肠系膜上动脉闭塞致严重并发症1例  

A case of severe complications caused by superior mesenteric artery occlu sion treated by combination of traditional Chinese and Western medicine

作　　者：林忠智 周世勇 傅定然 LIN Zhongzhi;ZHOU Shiyong;FU Dingran(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China)

机构地区：[1]贵州中医药大学,贵州贵阳550002

出　　处：《当代医药论丛》2023年第14期186-189,共4页

摘　　要：本文报道了1例肠系膜上动脉(SMA)闭塞致严重并发症患者:女性,57岁,入院前无明显诱因出现上腹部疼痛,呈间歇性隐痛,持续时间1~2 h,伴呃逆。入院完善相关检查,诊断为:(1)SMA栓塞;(2)小肠坏死并弥漫性腹膜炎;(3)腹主动脉多发溃疡并血肿、主动脉硬化。患者签署手术同意书后在全麻下行经SMA切开Fogarty球囊扩张动脉成形+肠系膜动脉取栓术+肠切除吻合术,术中取出SMA中2 cm栓塞物,根据患者肠管坏死情况切除约200 cm小肠。术后转入ICU监护治疗,后转入普通病房,术后患者表现为典型的“断肠综合征”症状,门诊长期口服中药(辨证用药)治疗,病情基本得到控制。This paper reports a case of a 57-year-old female with severe complications caused by superior mesenteric artery(SMA)occlusion.The patient presented with intermittent dull pain with hiccup for 1-2 hours without obvious inducement before admission.After admission,relevant examinations were completed and the diagnosis was:(1)SMA embolism;(2)Small intestine necrosis with diffuse peritonitis;(3)Multiple abdominal aortic ulcers with hematoma and aortic sclerosis.After the patient signed the surgical consent,Fogarty balloon dilatation arterioplasty via SMA,mesenteric artery thrombectomy,intestinal resection and anastomosis were performed under general anesthesia.During the operation,2 cm of SMA embolism was removed,and about 200 cm of small intestine was removed according to the patient’s intestinal tube necrosis.After the operation,t he patient was transferred to ICU for care and treatment,and then transferred to the general ward.After the operation,the patient showed typical symptoms of“broken gut syndrome”,and the disease was basically controlled by long-term oral Chinese medicine(sy ndrome differentiation)treatment in the outpatient department.

关 键 词：急性肠系膜上动脉闭塞 肠坏死 弥漫性腹膜炎 中西医结合治疗 

分 类 号：R574[医药卫生—消化系统]