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创伤性肠梗死(作者译)

[Traumatic intestinal infarction (author's transl)].

作者信息

Dubois F, de la Vaissière G, Pouliquen E

出版信息

J Chir (Paris). 1979 May;116(5):343-8.

PMID:489684
Abstract

A study of 25 cases of traumatic intestinal infarction, often old cases, did not show any characteristic clinical picture or course but showed the following points: --abdominal contusion, even mild, may induce intestinal infarction, without any other intra- or retroperitoneal lesion. The frequency of infarction is low, but the notion of trauma is often neglected; --the ileum and ascending colon are most commonly involved, and infarction usually follows a thrombosis of the mesenteric veins. When there is an arterial infarction, this is usually due to mobilisation of an atheromatous plaque; --the clinical course usually includes an interval between the trauma and the infarction, due to a prodromic phase corresponding to the constitution then the extension of the thrombosis. These characteristics suggest a relationship between infarction and venous infarction in general, especially postoperative infarction, where there is local trauma and slowing of the circulation and hypercoagulability and raised platelet count. The treatment is nevertheless the same, associating intestinal resection and exploration with endarterectomy of the vascular pedicles and prolonged postoperative anticoagulant treatment.

摘要

一项对25例创伤性肠梗死病例(多为陈旧病例)的研究显示,该病并无任何特征性临床表现或病程,但有以下几点:——腹部挫伤,即使是轻度的,也可能引发肠梗死,而无任何其他腹腔内或腹膜后病变。梗死发生率较低,但创伤这一因素常被忽视;——回肠和升结肠最常受累,梗死通常继发于肠系膜静脉血栓形成。当发生动脉性梗死时,通常是由于动脉粥样斑块的移动所致;——临床病程通常包括创伤与梗死之间的间隔期,这是由于血栓形成的前驱期以及随后血栓的扩展。这些特征提示一般情况下梗死与静脉梗死之间存在关联,尤其是术后梗死,术后存在局部创伤、循环减慢、血液高凝状态以及血小板计数升高。然而,治疗方法相同,即联合肠切除和探查,同时进行血管蒂内膜切除术以及术后长期抗凝治疗。

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