Kortmann B, Klar E
Abt. für Allgemeine, Thorax-, Gefäss- und Transplantationschirurgie, Chirurgische Universitätsklinik Rostock.
Zentralbl Chir. 2005 Jun;130(3):223-6. doi: 10.1055/s-2005-836544.
Survival of patients with acute mesenteric ischaemia is decisively dependent upon early diagnosis and non-delayed treatment. Maximum shortening of the admission-to-treatment-time is the main task, as the prehospital phase (e. g. symptom-to-admission-interval) varies considerably and is hardly to be influenced. "Acute mesenteric ischaemia" should early be considered as a possible diagnosis in patients presenting with abdominal symptoms of unknown cause bearing risk-factors for intestinal ischaemic disorders. In such cases an immediate angiography is the method of choice to confirm the diagnosis. To avoid irreversible intestinal damage, immediate laparotomy is induced if competent conducted angiography is not available within one hour after suspicion of intestinal ischaemia.
急性肠系膜缺血患者的存活决定性地依赖于早期诊断和不延迟治疗。最大程度缩短入院至治疗时间是主要任务,因为院前阶段(例如症状出现至入院间隔)差异很大且几乎无法受到影响。对于出现不明原因腹部症状且有肠道缺血性疾病风险因素的患者,应尽早将“急性肠系膜缺血”视为可能的诊断。在这种情况下,立即进行血管造影是确诊的首选方法。为避免不可逆的肠道损伤,如果在怀疑肠道缺血后一小时内无法进行有效的血管造影,则应立即进行剖腹手术。