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目的总结急性肠系膜缺血性疾病的早期诊治经验。方法回顾性分析1988～2007年间诊治的35例急性肠系膜缺血性疾病患者的临床资料。发生在肠系膜动脉30例,肠系膜静脉5例。主要临床表现为急性腹痛(94%);51%的患者有血清酶谱异常。结果全部病例均通过手术得以证实。4例行肠系膜上动脉置管溶栓,15例行 Fogarty 导管取栓术,16例行肠管切除。总病死率为23%,肠管坏死病例病死率为50%,多例患者术后出现再灌注损伤。结论动态观察血清酶谱变化有助于该类疾病的早期诊断,对术后再灌注损伤要高度重视。
Objective To summarize the early diagnosis and treatment of acute mesenteric ischemic disease. Methods The clinical data of 35 patients with acute mesenteric ischemic disease who were diagnosed and treated between 1988 and 2007 were retrospectively analyzed. Occurred in 30 cases of mesenteric artery, mesenteric vein in 5 cases. The main clinical manifestation was acute abdominal pain (94%); 51% of patients had abnormal serum enzymes. Results All cases were confirmed by surgery. 4 cases of superior mesenteric artery catheter thrombolysis, 15 cases of Fogarty catheter embolectomy, 16 cases of intestinal resection. The total case fatality rate was 23%. The case fatality rate of intestinal necrosis was 50%. Many patients had postoperative reperfusion injury. Conclusions Dynamic observation of serum zymogram changes is helpful for the early diagnosis of these diseases, and the postoperative reperfusion injury should be highly valued.