经皮动脉血栓清除术治疗早期急性肠系膜上动脉栓塞的临床疗效  

Clinical effect of percutaneous arterial thrombus removal in the treatment of early acute superior mesenteric artery embolism

作　　者：徐立 李文献 蔡符袁 Xu Li;Li Wenxian;Cai Fuyuan(Department of Vascular Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,Fujian,China)

机构地区：[1]福建医科大学附属漳州市医院血管外科,福建漳州363000

出　　处：《血管与腔内血管外科杂志》2024年第12期1449-1453,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨经皮动脉血栓清除术治疗早期急性肠系膜上动脉栓塞的疗效。方法收集2021年4月至2024年4月于福建医科大学附属漳州市医院收治的10例患者,均先行经皮动脉血栓清除术,术前可疑腹膜炎患者在血栓清除后立即进行剖腹探查,术后给予抗凝治疗并继续观察,记录患者的技术成功率、治疗情况等。结果10例患者腔内治疗技术成功率为100%。3例术前可疑有腹膜炎,均在血栓清除后立即进行了剖腹探查,2例发现肠坏死,分别切除了60 cm、10 cm的空肠。9例术后恢复良好,顺利出院;1例肠切除术后出现严重感染、心功能衰竭,自动出院。随访6~36个月,1例有慢性腹痛,其他患者均无不适。结论经皮动脉血栓清除术治疗早期急性肠系膜上动脉栓塞安全有效,可疑有腹膜炎的患者需积极开腹探查。Objective To investigate the effect of percutaneous arterial thrombus removal in the treatment of early acute superior mesenteric artery embolism.Method Clinical data of 10 patients admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from April 2021 to April 2024 were collected.Percutaneous arterial thrombus removal was performed in all patients first.The patients with suspected peritonitis were examined by laparotomy immediately after thrombus removal before surgery,and anticoagulant treatment was given after surgery and continued observation.The technical success rate and treatment status of the patients were recorded.Result The success rate of intracavitary therapy in 10 patients was 100%.Three cases were suspected to have peritonitis before operation,all of which were examined by laparotomy immediately after thrombus removal.Intestinal necrosis was found in two cases,and the jejunum of 60 cm and 10 cm were removed,respectively.9 cases recovered well after operation and were discharged smoothly.One case was discharged automatically after enterectomy due to severe infection and heart failure.During 6-36 months of follow-up,1 patient had chronic abdominal pain,while the other patients had no discomfort.Conclusion Percutaneous arterial thrombus removal is safe and effective in the treatment of early acute superior mesenteric artery embolization.Active exploratory laparotomy is required for patients suspected of peritonitis.

关 键 词：经皮动脉血栓清除术 急性肠系膜上动脉栓塞 腹膜炎 

分 类 号：R543[医药卫生—心血管疾病]