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[急性肠系膜动脉闭塞——临床特点、治疗及预后]

[Acute mesenteric artery occlusion--clinical aspects, therapy, prognosis].

作者信息

Braun L

出版信息

Zentralbl Chir. 1985;110(24):1527-36.

PMID:4090784
Abstract

During the last 10 years 52 patients with acute mesenteric artery occlusion underwent surgery. There were 19 males and 33 females with a mean age of 73.0 years. 33 patients (63.5%) died postoperatively within 30 days. In 12 cases laparotomy demonstrated inoperability. Resections of the necrotic small intestine were performed in 21 cases, in 6 cases also of the colon. Resections of the intestine were combined in 16 cases with vascular procedures (embolectomy or thrombendarterectomy of the mesenteric superior artery or implantation of aorto-mesenterial or iliaco-mesenterial bypass). In 5 patients a second look - operation was performed with 2 survivors. In 3 cases the clinical diagnosis of mesenteric artery occlusion was proven by preoperative angiography. The prognosis of acute intestinal ischemia can only be improved by early diagnosis and operative treatment. Surgery is aimed at removing the necrotic tissue and restoring an adequate blood flow to the remaining bowel.

摘要

在过去10年中,52例急性肠系膜动脉闭塞患者接受了手术治疗。其中男性19例,女性33例,平均年龄73.0岁。33例患者(63.5%)术后30天内死亡。12例患者剖腹探查显示无法手术。21例行坏死小肠切除术,6例同时切除结肠。16例肠切除术联合血管手术(肠系膜上动脉栓子切除术或血栓内膜切除术,或主动脉-肠系膜或髂动脉-肠系膜旁路移植术)。5例患者进行了二次手术,2例存活。3例患者术前血管造影证实了肠系膜动脉闭塞的临床诊断。急性肠缺血的预后只能通过早期诊断和手术治疗来改善。手术旨在切除坏死组织并恢复剩余肠段的充足血流。

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