摘要目的 探讨急性肠系膜上动脉缺血的诊治方法,提高诊治水平.方法 回顾分析1996年1月至2007年8月收治的37例急性肠系膜上动脉缺血患者的临床资料,结合文献讨论其病因、诊断及治疗.结果 急性肠系膜上动脉栓塞19例(51.4%),急性肠系膜上动脉血栓形成15例(40.5%),孤立的肠系膜上动脉夹层2例(5.4%),肠系膜上动脉瘤1例(2.7%).急诊误诊19例(51.4%).院内死亡18例(48.6%),多死于重症感染和多器官功能衰竭.存活的19例中3例遗留严重后遗症(短肠综合征2例,脑出血1例).共9例患者获得随访,平均随访15个月,其间5例死亡.结论 急性肠系膜上动脉缺血病因多样,早期干预可显著改善患者预后.

abstractsObjective To study the management of acute superior mesenteric artery(SMA)ischemia and to ireprove its prognosis.Method The clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed.Results Of the cases,19(51.4%)patients were diagnosed with acute SMA embolism,15(40.5%)with acute SMA thrombosis,2(5.4%)with spontaneous isolated dissection of SMA and 1(2.7%)with SMA aneurysm. Nineteen(51.4%)patients were misdiagnosed in emergency.Eighteen(48.6%)patients died in the hospital,and most of them died of severe infection and multiple organ failure.Three cases of the survived 19 patients experienced severe complications(2 with short gut syndrome,1 with cerebral hemorrhage).Nine cases were followed-up for a mean period of 15 months,and 5 died during that term.Conclusions Acute SMA ischemia has multiple etiological factors.Early intervention can improve the prognosis.