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[急性肠系膜缺血的早期诊断。病例系列与临床综述]

[Early diagnosis in acute mesenteric ischemia. Case series and clinical review].

作者信息

Zuccon William, Creperio Giampietro, Paternollo Roberto, Iamele Angelo, Pagani Maurizio, Bianchi Massimo, Bernardin Elena, Familiari Guido

机构信息

Struttura Complessa di Chirurgia Generale 1a.

出版信息

Ann Ital Chir. 2010 May-Jun;81(3):183-92.

PMID:21105481
Abstract

The AA report on 12 cases of intestinal infarction for acute mesenteric ischemia (IMA) in critical patients observed in the last 2 years. In this work some clinical data, blood tests and strumental considerations are described. IMA is a vascular emergency with severe prognosis and high rate morbidity and mortality, often correlated to a diagnostic delay. The discrepancy between symptoms and clinical objectivity must suggest the suspect, especially in patients with cardiac pathology, short lasting diarrhoea, bowel hemorrhage or only abdominal pain rebel to the analgesics; with the laboratory indexes and strumental data it can be carried out an early diagnosis and then begin the more opportune therapeutical treatment. The increase of blood sugar together to the triad leucocytosis--haemoconcentration and metabolic acidosis, in previously non diabetic patients, confirm the suspect of IMA in the very initial phases of this pathology.

摘要

该协会报告了过去2年中观察到的12例危重症患者因急性肠系膜缺血(IMA)导致肠梗死的病例。在这项工作中,描述了一些临床数据、血液检查和器械检查方面的情况。IMA是一种血管急症,预后严重,发病率和死亡率高,常与诊断延迟相关。症状与临床客观表现之间的差异必须引起怀疑,尤其是在患有心脏疾病、短暂性腹泻、肠道出血或仅腹痛且对镇痛药无反应的患者中;结合实验室指标和器械检查数据,可以进行早期诊断,然后开始更合适的治疗。在既往无糖尿病的患者中,血糖升高伴白细胞增多、血液浓缩和代谢性酸中毒三联征,在该疾病的最初阶段即可证实IMA的怀疑。

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1
[Early diagnosis in acute mesenteric ischemia. Case series and clinical review].[急性肠系膜缺血的早期诊断。病例系列与临床综述]
Ann Ital Chir. 2010 May-Jun;81(3):183-92.
2
[Acute ischemia and arterial mesenteric infarction in patients aged over 75. Apropos of a comparative series of 38 cases].[75岁以上患者的急性缺血性肠系膜动脉梗死。附38例对比研究]
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Nonocclusive mesenteric ischemia remains a diagnostic dilemma.非阻塞性肠系膜缺血仍然是一个诊断难题。
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