Clinical Experience of Acute Superior Mesenteric Artery Ischemia in 41 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 银东智 ¹ ,  袁又能 ¹ , 左燕妮 ¹ , 王珍 ²

1. ;
2. ;

Corresponding author：

袁又能, Email: yuanyouneng@126.com

Keywords：

急性肠系膜上动脉缺血性疾病; 栓塞; 血栓形成; 治疗

DOI：

10.7507/1007-9424.20140086

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的总结急性肠系膜上动脉缺血性疾病的外科治疗经验。方法对黄石市中心医院2002年1月至2013年6月期间收治的41例急性肠系膜上动脉缺血性疾病患者的临床资料进行回顾性分析。结果 41例急性肠系膜上动脉缺血性疾病患者中，行手术治疗40例（术中死亡2例），行介入溶栓治疗1例。术后出现短肠综合征9例，死亡19例。出院后27例患者获访，随访时间为1周～2年（平均随访时间为1.4年）。随访期间，因家属放弃治疗而于家中死亡7例，转院后于他院死亡4例，3例未愈或复发，13例痊愈（1例行介入溶栓治疗）。结论急性肠系膜上动脉缺血性疾病的不同进展阶段其临床特征有所差异，术前CT血管造影（CTA）检查的意义重大。早期诊断、早期治疗、根据病情不同阶段选择合适的治疗方案（手术、介入治疗、药物治疗等）是降低死亡率的关键。

Citation： 银东智, 袁又能, 左燕妮, 王珍. Clinical Experience of Acute Superior Mesenteric Artery Ischemia in 41 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(3): 358-360. doi: 10.7507/1007-9424.20140086 Copy

1.	Kassahun WT, Schulz T, Richter O, et al. Unchanged high mortality rates from acute occlusive intestinal ischemia:six year review[J]. Langenbecks Arch Surg, 2008, 393(2):163-171.
2.	Lock G. Acute mesenteric ischemia:classification, evaluation and therapy[J]. Acta Gastroenterol Belg, 2002, 65(4):220-225.
3.	狄茂军, 付应峰, 兰明银, 等.血清D-二聚体测定对急性肠系膜上动脉栓塞的诊断价值[J].腹部外科, 2008, 21(2):110-111.
4.	Schoots IG, Koffeman GI, Legemate DA, et al. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology[J]. Br J Surg, 2004, 91(1):17-27.
5.	Acosta S, Ogren M, Sternby NH, et al. Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery-a population-based study[J]. Eur J Vasc Endovasc Surg, 2004, 27(2):145-150.
6.	Bergan JJ, Dean RH, Conn J Jr, et al. Revascularization in treatment of mesenteric infarction[J]. Ann Surg, 1975, 182(4):430-438.
7.	Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia:initial experience[J]. Radiology, 2003, 229(1):91-98.
8.	Barmase M, Kang M, Wig J, et al. Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia[J]. Eur J Radiol, 2011, 80(3):e582-e587.
9.	Wadman M, Block T, Ekberg O, et al. Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion[J]. Emerg Radiol, 2010, 17(3):171-178.
10.	辛世杰, 王雷.急性肠系膜血管缺血性疾病病因及处理[J].中国实用外科杂志, 2009, 29(11):903-906.
11.	Wyers MC. Acute mesenteric ischemia:diagnostic approach and surgical treatment[J]. Semin Vasc Surg, 2010, 23(1):9-20.
12.	王春喜, 王新文, 李荣, 等.急性肠系膜上动脉栓塞的手术探讨[J].中国现代手术学杂志, 2006, 10(3):174-178.
13.	Ott R, Hartwig T, Tannapfel A, et al. Biocompatibility of bacterial contaminated prosthetic meshes and porcine dermal collagen used to repair abdominal wall defects[J]. Langenbecks Arch Surg, 2007, 392(4):473-478.
14.	Yasuhara H. Acute mesenteric ischemia:the challenge of gastroenterology[J]. Surg Today, 2005, 35(3):185-195.
15.	Paterno F, Longo WE. The etiology and pathogenesis of vascular disorders of the intestine[J]. Radiol Clin North Am, 2008, 46(5):877-885.

1. Kassahun WT, Schulz T, Richter O, et al. Unchanged high mortality rates from acute occlusive intestinal ischemia:six year review[J]. Langenbecks Arch Surg, 2008, 393(2):163-171.
2. Lock G. Acute mesenteric ischemia:classification, evaluation and therapy[J]. Acta Gastroenterol Belg, 2002, 65(4):220-225.
3. 狄茂军, 付应峰, 兰明银, 等.血清D-二聚体测定对急性肠系膜上动脉栓塞的诊断价值[J].腹部外科, 2008, 21(2):110-111.
4. Schoots IG, Koffeman GI, Legemate DA, et al. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology[J]. Br J Surg, 2004, 91(1):17-27.
5. Acosta S, Ogren M, Sternby NH, et al. Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery-a population-based study[J]. Eur J Vasc Endovasc Surg, 2004, 27(2):145-150.
6. Bergan JJ, Dean RH, Conn J Jr, et al. Revascularization in treatment of mesenteric infarction[J]. Ann Surg, 1975, 182(4):430-438.
7. Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia:initial experience[J]. Radiology, 2003, 229(1):91-98.
8. Barmase M, Kang M, Wig J, et al. Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia[J]. Eur J Radiol, 2011, 80(3):e582-e587.
9. Wadman M, Block T, Ekberg O, et al. Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion[J]. Emerg Radiol, 2010, 17(3):171-178.
10. 辛世杰, 王雷.急性肠系膜血管缺血性疾病病因及处理[J].中国实用外科杂志, 2009, 29(11):903-906.
11. Wyers MC. Acute mesenteric ischemia:diagnostic approach and surgical treatment[J]. Semin Vasc Surg, 2010, 23(1):9-20.
12. 王春喜, 王新文, 李荣, 等.急性肠系膜上动脉栓塞的手术探讨[J].中国现代手术学杂志, 2006, 10(3):174-178.
13. Ott R, Hartwig T, Tannapfel A, et al. Biocompatibility of bacterial contaminated prosthetic meshes and porcine dermal collagen used to repair abdominal wall defects[J]. Langenbecks Arch Surg, 2007, 392(4):473-478.
14. Yasuhara H. Acute mesenteric ischemia:the challenge of gastroenterology[J]. Surg Today, 2005, 35(3):185-195.
15. Paterno F, Longo WE. The etiology and pathogenesis of vascular disorders of the intestine[J]. Radiol Clin North Am, 2008, 46(5):877-885.

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Clinical Experience of Acute Superior Mesenteric Artery Ischemia in 41 Cases

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