Hallett J W, James M E, Ahlquist D A, Larson M V, McAfee M K, Cherry K J
Department of Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Ann Vasc Surg. 1990 Mar;4(2):126-32. doi: 10.1007/BF02001366.
This paper reviews the operative management over the past 27 years of 102 patients with chronic mesenteric ischemia, and summarizes recent clinical trends and ongoing research in this area. The most important trends in the diagnosis and management of chronic intestinal ischemia include: (1) increasing use of duplex ultrasound scanning in the initial evaluation of patients with possible intestinal angina; (2) rapidly evolving noninvasive clinical tests to assess mucosal perfusion (reflectance spectrophotometry, laser Doppler flow analysis, and tonometry); and (3) preferential use of antegrade mesenteric grafts or transaortic endarterectomy for mesenteric atherosclerotic occlusive disease. Surgical revascularization continues to provide excellent early relief of symptoms (93%) and a low late recurrence rate (10%). New noninvasive diagnostic tests for chronic intestinal ischemia and excellent results of surgical revascularization support a continued aggressive approach to the early recognition and treatment of patients with chronic intestinal angina. With the aging population, we anticipate that the number of patients with chronic intestinal ischemia will increase.
本文回顾了过去27年中102例慢性肠系膜缺血患者的手术治疗情况，并总结了该领域近期的临床趋势和正在进行的研究。慢性肠缺血诊断和治疗中最重要的趋势包括：（1）在对可能患有肠绞痛的患者进行初步评估时，越来越多地使用双功超声扫描；（2）快速发展的评估黏膜灌注的非侵入性临床试验（反射分光光度法、激光多普勒血流分析和眼压测量法）；（3）对于肠系膜动脉粥样硬化闭塞性疾病，优先使用顺行肠系膜移植或经主动脉内膜切除术。手术血管重建术继续能在早期显著缓解症状（93%），且后期复发率较低（10%）。慢性肠缺血的新型非侵入性诊断试验以及手术血管重建术的良好效果支持对慢性肠绞痛患者继续采取积极的早期识别和治疗方法。随着人口老龄化，我们预计慢性肠缺血患者的数量将会增加。
