Urayama H, Ohtake H, Kawakami T, Tsunezuka Y, Yokoi K, Watanabe Y
First Department of Surgery, Kanazawa University School of Medicine, Ishikawa, Japan.
Eur J Surg. 1998 Mar;164(3):195-200. doi: 10.1080/110241598750004643.
To study the factors that influence mortality and long term outcome of patients with acute mesenteric vascular occlusion.
Retrospective study.
University hospital, Kanazawa, Japan.
Thirty-nine patients treated between 1978 and 1995 for acute mesenteric vascular occlusion.
34 patients underwent laparotomy. Bowel was resected in 29 patients, and primary anastomosis was done in 20. The occluded vessel was revascularised in 5 patients.
mortality, short bowel syndrome and long term survival.
25 patients had arterial occlusions, and 8 venous. In the remaining 6, the occluded vessel was not identified. 11 Patients developed renal failure, 11 respiratory failure, and 10 disseminated intravascular coagulation (DIC). Twelve patients died within 30 days. The factors associated with early death were acidosis and high serum amylase activity. 9 Patients developed the short bowel syndrome. Survival was 49% at 1 year, and 34% at 5 years.
Mortality was higher in patients with advanced peritonitis. Mesenteric revascularisation should be attempted to avoid the short bowel syndrome.
研究影响急性肠系膜血管闭塞患者死亡率及长期预后的因素。
回顾性研究。
日本金泽大学医院。
1978年至1995年间接受治疗的39例急性肠系膜血管闭塞患者。
34例患者接受剖腹手术。29例患者行肠切除术，20例进行一期吻合术。5例患者对闭塞血管进行了血运重建。
死亡率、短肠综合征及长期生存率。
25例患者为动脉闭塞，8例为静脉闭塞。其余6例未明确闭塞血管。11例患者发生肾衰竭，11例发生呼吸衰竭，10例发生弥散性血管内凝血（DIC）。12例患者在30天内死亡。与早期死亡相关的因素为酸中毒和高血清淀粉酶活性。9例患者发生短肠综合征。1年生存率为49%，5年生存率为34%。
晚期腹膜炎患者死亡率较高。应尝试进行肠系膜血运重建以避免短肠综合征。
