肠系膜上动脉急性血栓栓塞性闭塞的发病率——一项基于人群的研究。
Incidence of acute thrombo-embolic occlusion of the superior mesenteric artery--a population-based study.
作者信息
Acosta S, Ogren M, Sternby N-H, Bergqvist D, Björck M
机构信息
Department of Surgery, Blekinge County Hospital, Karlskrona, Sweden.
出版信息
Eur J Vasc Endovasc Surg. 2004 Feb;27(2):145-50. doi: 10.1016/j.ejvs.2003.11.003.
OBJECTIVE
To determine the incidence of acute thrombo-embolic occlusion of the superior mesenteric artery (AOSMA) in a population-based study.
MATERIAL
All clinical (n=23,446) and forensic (n=7569) autopsies performed in the city of Malmö between 1970 and 1982 (population 264,000-230,000 inhabitants). The autopsy rate was 87%.
METHODS
Calculation of the incidence of AOSMA with intestinal gangrene in those autopsies coded for bowel ischaemia (997/23,446 clinical and 9/7569 forensic autopsies). The operative procedures performed in 1970, 1976 and 1982 were also analysed.
RESULTS
Two forensic and 211 clinical autopsies demonstrated AOSMA with intestinal gangrene. Previous suspicion of intestinal ischaemia was noted in only 33%. Sixteen patients were operated. The cause-specific mortality was 6.0/1000 deaths. The incidence was 8.6/100,000 person years, increasing exponentially with age (p<0.001). Mortality was 93%.
CONCLUSIONS
The incidence and mortality of AOSMA is higher than previously reported from clinical series. There is seldom any suspicion of the diagnosis prior to death.
目的
在一项基于人群的研究中确定肠系膜上动脉急性血栓栓塞性闭塞（AOSMA）的发病率。
材料
1970年至1982年在马尔默市进行的所有临床尸检（n = 23446例）和法医尸检（n = 7569例）（人口264000 - 230000居民）。尸检率为87%。
方法
计算那些编码为肠道缺血的尸检中伴有肠坏疽的AOSMA发病率（997例临床尸检和9例法医尸检）。还分析了1970年、1976年和1982年进行的手术操作。
结果
2例法医尸检和211例临床尸检显示有伴有肠坏疽的AOSMA。之前仅有33%的病例被怀疑有肠道缺血。16例患者接受了手术。病因特异性死亡率为6.0/1000例死亡。发病率为8.6/100000人年，随年龄呈指数增长（p<0.001）。死亡率为93%。
结论
AOSMA的发病率和死亡率高于之前临床系列报道。死亡前很少有对该诊断的怀疑。
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