急性主动脉夹层合并肠系膜上动脉灌注不良的焦点问题和诊治现状  

A focal issue of acute aortic dissection complicated by superior mesenteric artery malperfusion and current status of its diagnosis and treatment

作　　者：胡斌[1,2] 李栋林 张鸿坤[1] Hu Bin;Li Donglin;Zhang Hongkun(Department of Vascular Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Vascular Surgery,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江大学医学院附属第一医院血管外科,杭州310000 [2]浙江省台州医院血管外科,台州317000

出　　处：《中华血管外科杂志》2024年第2期129-134,共6页Chinese Journal of Vascular Surgery

基　　金：浙江省基础公益研究计划项目(LGF20H020007)。

摘　　要：急性主动脉夹层导致的肠系膜上动脉灌注不良并不少见,可增加患者3~4倍的死亡率。同时,肠系膜上动脉灌注不良早期症状可不典型,且缺乏特异性的实验室指标或影像学表现,使其诊断具有挑战性。目前,国内外关于急性主动脉夹层合并肠系膜上动脉灌注不良的治疗策略仍存在争论,焦点问题是先进行主动脉修复还是恢复肠系膜上动脉血流灌注。本文就急性主动脉夹层合并肠系膜上动脉灌注不良的发病机制、诊断、治疗方案等进行综述,以期为临床工作者提供参考。Malperfusion of the superior mesenteric artery due to acute aortic dissection(AAD)is a common syndrome that can increase the mortality rate of patients with AAD by 3 to 4 times.Meanwhile,its diagnosis is challenging as the early symptoms of mesenteric malperfusion can be atypical,with a lack of specific laboratory indexes or imaging features.At present,the treatment strategy of AAD with mesenteric malperfusion maintains controversy at home and abroad,within which the focus question is whether to perform aortic repair first or to restore mesenteric perfusion first.This article aims to review the pathogenesis,diagnosis,and treatment of AAD with mesenteric malperfusion,in order to guide clinical practice.

关 键 词：主动脉夹层 肠系膜上动脉 灌注不良 诊治现状 

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