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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。
Objective To summarize the experience of surgical treatment of acute superior mesenteric artery ischemic disease. Methods The clinical data of 41 patients with acute superior mesenteric artery ischemic disease admitted to Central Hospital of Huangshi from January 2002 to June 2013 were analyzed retrospectively. Results Of the 41 patients with acute superior mesenteric artery ischemic disease, 40 cases were treated surgically (2 died during operation) and 1 case received thrombolytic therapy. Postoperative short bowel syndrome in 9 cases, 19 patients died. Twenty-seven patients were discharged from the hospital for a follow-up of 1 week to 2 years (mean follow-up, 1.4 years). During the follow-up period, 7 patients died at home due to family abandonment of treatment, 4 patients died of other hospitalizations after transfer, 3 patients recovered or recurred, and 13 patients recovered (1 received routine thrombolysis). Conclusions The clinical features of acute mesenteric artery ischemic disease at different stages of progression are different. Preoperative CT angiography (CTA) is of great significance. Early diagnosis, early treatment, according to different stages of the disease to choose the appropriate treatment options (surgery, interventional therapy, drug treatment, etc.) is the key to reducing mortality.