Killen D A, Reed W A, Gorton M E, Muehlebach G F, Borkon A M, Piehler J M, Wathanacharoen S
MidAmerica Heart Institute, Saint Luke's Hospital, and the Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Ann Vasc Surg. 1999 Sep;13(5):533-8. doi: 10.1007/s100169900293.
All patients with an abdominal aortic aneurysm treated during a 27-year period by one surgical group at the MidAmerica Heart Institute were included in this study. A prospective routine postaneurysmectomy hemodynamic assessment of the inferior mesenteric artery (IMA) circulation was performed in a test group of consecutive patients operated on by one surgeon. When a mean IMA stump pressure </= approximately 50 mmHg was found, the IMA was reimplanted. Postoperatively, patients were monitored for clinical evidences of ischemic colitis. The occurrence of ischemic colonic injury was documented by colonoscopy, laparotomy, or autopsy. The incidences of ischemic colitis in the test group, a historical control group, and a concomitant control group were determined and compared. Routine hemodynamic assessment of the postaneurysmectomy IMA circulation did not favorably affect the outcome with regard to the occurrence of clinically evident ischemic colitis.
本研究纳入了中美心脏研究所一个外科团队在27年期间治疗的所有腹主动脉瘤患者。在一组由一名外科医生连续进行手术的患者组成的试验组中，对肠系膜下动脉（IMA）循环进行了前瞻性常规动脉瘤切除术后血流动力学评估。当发现IMA残端平均压力≤约50 mmHg时，将IMA重新植入。术后，对患者进行缺血性结肠炎临床证据的监测。通过结肠镜检查、剖腹手术或尸检记录缺血性结肠损伤的发生情况。确定并比较了试验组、历史对照组和同期对照组中缺血性结肠炎的发生率。就临床明显的缺血性结肠炎的发生而言，常规的动脉瘤切除术后IMA循环血流动力学评估对结果没有产生有利影响。
