急性肠系膜动静脉缺血性疾病的临床特征分析

摘要

Objective To analyze the clinical characteristics of acute mesenteric ischemic diseases.Methods Twenty-eight patients with acute mesenteric ischemic diseases in Renmin Hospital Affiliated to Hubei University of Medicine were selected as the research objects.Clinical data of all patients were collected to analyze the characteristics of acute mesenteric ischemic diseases.Results There were 14 cases (50.0％) of mesenteric venous ischemia and 12 cases(42.9％) of mesenteric arterial ischemia,2 cases (7.1％) were not identified.In patients with venous ischemia,10 cases were complicated with liver cirrhosis,6 cases were complicated with cerebral infarction and 2 cases were complicated with atrial fibrillation;in patients with arterial ischemia,4 cases were complicated with atrial fibrillation and 2 cases were complicated with myocardial infarction.After treatment,21 cases were cured(20 cases had surgical treatment) and 7 cases died(6 cases had surgical treatment).The major clinical manifestations of 28 patients were nonspecific symptoms,intestinal obstruction,peritonitis and abdominal cramp-fever-jaundice triad.In 14 patients with nonspecific symptoms,13 patients were cured and 1 patient died;3 cases of intestinal obstruction ended up with death;4 cases were cured and 2 cases died in peritonitis patients(6 cases);4 cases were cured and 1 case died in cramp-fever-jaundice patients (5 cases).Conclusion The clinical features of acute mesenteric ischemic diseases are complex,the major manifestations are nonspecific symptoms,intestinal obstruction,peritonitis and abdominal cramp-fever-jaundice triad.%目的 分析急性肠系膜动静脉缺血性疾病的临床特征.方法 选取湖北医药学院附属人民医院2015年1月至2016年1月收治的28例急性肠系膜动静脉缺血性患者作为研究对象,分析所有患者的临床资料,探讨急性肠系膜动静脉缺血性疾病患者的临床特征.结果 28例患者中急性肠系膜静脉缺血14例(50.0％),急性肠系膜动脉缺血12例(42.9％),病变血管不确定2例(7.1％).14例静脉缺血患者中伴有肝硬化10例,伴有脑梗死6例,伴有心房颤动2例;12例动脉缺血患者中伴有心房颤动4例,伴有心肌梗死2例.28例患者中26例采用手术治疗,治愈21例(手术治疗20例),死亡7例(手术治疗6例).28例患者临床特征主要体现为非特异症状、肠梗阻、腹膜炎以及三联征(腹部绞痛、寒战发热及黄疸);其中14例无特异性症状患者治愈13例,死亡1例;3例肠梗阻患者均死亡;6例腹膜炎患者治愈4例,死亡2例;5例三联症患者治愈4例,死亡1例.结论 急性肠系膜动静脉缺血性疾病的临床特征较为复杂,主要表现为非特异症状、肠梗阻、腹膜炎以及三联征.