自发性孤立性肠系膜上动脉夹层的诊断及治疗策略

摘要

Objective To discuss the clinical features,diagnosis,classification and treatment strategy of a rare disease,spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods The clinical data of 12 patients with SISMAD were retrospectively analyzed.Based on the clinical features,SISMAD was classified into the simple type and the complicated type.Results All the patients were defined as the simple type.Among them,10 patients underwent conservative treatment,2 patients were performed with routine interventional therapy.Clinical symptoms were relieved in all cases.Follow-up 9-140 months,computed tomography angiography showed diminished extent of the false lumen without any view of new thrombosis or embolism.No patient showed dissection progression on follow-up angiogram.Conclusions For the simple type,most cases might be successfully treated with conservative treatment,and the short-term and long-term results are good.And endovascular stent placement appears to be an acceptable alternative,however,its long-term result needs further investigation.%目的 探讨自发性孤立性肠系膜上动脉夹层(SISMAD)这一罕见疾病的临床特点、诊断、临床分型及治疗策略.方法 回顾性分析12例SISMAD患者的临床资料,根据临床表现将SISMAD分为单纯型和复杂型.结果 12例患者均为单纯型.其中10例行保守治疗,2例行腔内介入治疗.12例患者临床症状均缓解,随访9～140个月,CT血管造影提示肠系膜上动脉夹层未进展,假腔有不同程度减小,未见新血栓发生.结论 对于单纯型SISMAD患者,保守治疗能获得良好的短期和中长期疗效.腔内介入治疗具有创伤小,见效快且效果明显等优势,但远期疗效仍需长期随访.