【摘要】 目的探讨急性肠系膜血管缺血性疾病(acute mesenteric ischemia,AMI)的诊断和治疗方法。方法回顾性分析16例AMI患者的临床资料。16例急诊行64排128层螺旋CT扫描及三维重建,诊断为肠系膜上动脉栓塞6例、肠系膜下动脉栓塞1例、肠系膜上静脉血栓形成7例(同时伴有门静脉血栓形成2例),阳性率87.5%,阴性结果2例,再行选择性肠系膜上动脉造影,诊断为肠系膜上动脉血栓形成。4例接受以溶栓为主的非手术治疗,12例行急诊手术。结果非手术治疗的4例症状、体征均消失,肠管功能恢复正常,痊愈出院。12例手术患者中11例痊愈出院,1例死亡,死亡原因为MODS。结论AMI早期诊断意义重大,128层加强螺旋CT肠系膜血管成像有助于AMI的早期诊断,早期溶栓和及时手术切除坏死肠管,对挽救患者的生命有重要意义。更多还原

【Abstract】 Objective To explore the diagnostic and therapeutic methods and effects for acute mesenteric ischemia(AMI).Methods Clinical data of AMI in 16 cases was retrospectively analyzed.14 patients were diagnosed as superior mesenteric artery embolism of 6,inferior mesenteric artery embolism of 1,superior mesenteric vein thrombosis of 7 by spiral and multi-slice computed tomography and vascular three-dimensional reconstruction.And the other 2 CT-negative cases were diagnosed as superior mesenteric artery thrombosis.4 cases received non-operative therapy in major of thrombolysis,and the other 12 got emergency operations.Results The 4 non-operative patients were cured without symptom and sign.11 surgical patients got healed,but 1 died of MODS.Conclusions The early diagnosis is important to the AMI,in which it plays a key role of the spiral and multi-slice computed tomography and vascular three-dimensional reconstruction.The early thrombolysis and prompt enterectomy of the necrosis bowl are the key points to save the lives of AMI.更多还原