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目的:预测急性肠系膜缺血性疾病的不良结局的危险因素。方法:收集惠州市第一人民医院2010年1月至2016年5月经血管造影或病理确诊急性肠系膜缺血性疾病52例患者的临床和实验室数据。结果:肠系膜动脉栓塞或血栓形成、肠系膜静脉血栓形成和非阻塞性肠系膜缺血占急性肠系膜缺血性疾病的病因分别为32例(62.5%),14例(27%),和6例(10.5%)。腹痛是最常见的症状有48例(92.1%)、腹膜炎46例(86.7%)和休克12例(21.5%)。腹部CT血管造影42例(81%)。大多数患者进行了手术,6例(12%)患者进行了第二次手术,死亡率为40.3%。死亡的主要原因为多器官衰竭(42%)。结论:使用抗血小板药物及地高辛,症状持续到手术前的时间,存在休克,严重酸中毒和再手术可能增加患者的死亡率;CT血管造影、外科早期干预和肠外营养支持可能改善患者生存。
PURPOSE: To predict the risk factors for adverse outcome of acute mesenteric ischemic disease. Methods: The clinical and laboratory data of 52 patients with acute mesentery ischemic disease confirmed by angiography or pathology from January 2010 to May 2016 in Huizhou First People’s Hospital were collected. RESULTS: The causes of mesenteric artery thrombosis, thrombus formation, mesenteric venous thrombosis and non-obstructive mesentery ischemia were 32 (62.5%), 14 (27%), and 6 %). Abdominal pain was the most common symptoms in 48 cases (92.1%), peritonitis in 46 cases (86.7%) and shock in 12 cases (21.5%). Abdominal CT angiography in 42 cases (81%). Most patients underwent surgery, and 6 (12%) had a second surgery with a 40.3% mortality rate. The main cause of death was multiple organ failure (42%). CONCLUSION: The use of antiplatelet agents and digoxin, with symptoms persisting to pre-operative time, presence of shock, severe acidosis and reoperation may increase patient mortality; CT angiography, early surgery intervention, and parenteral nutrition support may improve patients survive.