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

Authors：

 銀東智 ¹ ,  袁又能 ¹ , 左燕妮 ¹ , 王珍 ²

1. ;
2. ;

Corresponding?author：

袁又能, Email: yuanyouneng@126.com

Keywords：

急性腸系膜上動脈缺血性疾病; 栓塞; 血栓形成; 治療

DOI：

10.7507/1007-9424.20140086

Video：

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目的總結急性腸系膜上動脈缺血性疾病的外科治療經驗。方法對黃石市中心醫院2002年1月至2013年6月期間收治的41例急性腸系膜上動脈缺血性疾病患者的臨床資料進行回顧性分析。結果 41例急性腸系膜上動脈缺血性疾病患者中，行手術治療40例（術中死亡2例），行介入溶栓治療1例。術后出現短腸綜合征9例，死亡19例。出院后27例患者獲訪，隨訪時間為1周～2年（平均隨訪時間為1.4年）。隨訪期間，因家屬放棄治療而于家中死亡7例，轉院后于他院死亡4例，3例未愈或復發，13例痊愈（1例行介入溶栓治療）。結論急性腸系膜上動脈缺血性疾病的不同進展階段其臨床特征有所差異，術前CT血管造影（CTA）檢查的意義重大。早期診斷、早期治療、根據病情不同階段選擇合適的治療方案（手術、介入治療、藥物治療等）是降低死亡率的關鍵。

Citation： 銀東智, 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.	狄茂軍, 付應峰, 蘭明銀, 等.血清D-二聚體測定對急性腸系膜上動脈栓塞的診斷價值[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.急性腸系膜血管缺血性疾病病因及處理[J].中國實用外科雜志, 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, 李榮, 等.急性腸系膜上動脈栓塞的手術探討[J].中國現代手術學雜志, 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. 狄茂軍, 付應峰, 蘭明銀, 等.血清D-二聚體測定對急性腸系膜上動脈栓塞的診斷價值[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.急性腸系膜血管缺血性疾病病因及處理[J].中國實用外科雜志, 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, 李榮, 等.急性腸系膜上動脈栓塞的手術探討[J].中國現代手術學雜志, 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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