Björck M, Bergqvist D, Troëng T
Department of Surgery, Skellefteå District Hospital, Sweden.
Eur J Vasc Endovasc Surg. 1996 Aug;12(2):139-44. doi: 10.1016/s1078-5884(96)80098-0.
To study the incidence and clinical presentation of intestinal ischaemia after aortoiliac/femoral surgery, and to validate a vascular registry concerning a serious complication.
In the Swedish Vascular Registry (SWEDVASC) the outcome and complications of all vascular procedures are registered prospectively.
All 2930 patients operated in 1987-93 were analysed for notified complications. A 5% random sample of all patients and a 20% random sample of fatal cases were analysed for un-notified complications. Of 415 requested patient records 413 were analysed.
The estimated incidence of bowel ischaemia was 2.8%. Among patients operated on for a ruptured aneurysm in shock it was 7.3%. Of the 63 patients with intestinal ischaemia only 15 presented with early passage of bloody stools. In 60 patients (95%) the lesion affected the left colon within the reach of a sigmoidoscope. Bowel ischemia was unnotified only in fatal cases, the estimated un-notified complication rate was 0.7%.
The incidence in this study on unselected patients did not differ from previous reports from specialised centres. Diagnosis is difficult and justifies a high index of suspicion and early use of sigmoidoscopy. The validity of the SWEDVASC registry was confirmed by a high report-rate for this complication.
研究主髂动脉/股动脉手术后肠道缺血的发生率及临床表现，并验证一个关于严重并发症的血管登记系统。
在瑞典血管登记系统（SWEDVASC）中，前瞻性登记了所有血管手术的结果及并发症。
分析了1987年至1993年接受手术的2930例患者的报告并发症情况。对所有患者的5%随机样本及所有死亡病例的20%随机样本分析未报告的并发症。在415份索要的患者记录中，分析了413份。
肠道缺血的估计发生率为2.8%。在因休克性动脉瘤破裂接受手术的患者中，发生率为7.3%。在63例肠道缺血患者中，仅15例出现早期便血。60例患者（95%）的病变累及乙状结肠镜可及范围内的左半结肠。仅在死亡病例中肠道缺血未被报告，估计未报告的并发症发生率为0.7%。
本研究中对未选择患者的发生率与之前专业中心的报告无差异。诊断困难，需要高度怀疑并尽早使用乙状结肠镜检查。该并发症的高报告率证实了SWEDVASC登记系统的有效性。
