DSA下杂交手术治疗肠系膜上动脉栓塞(1)
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[摘要] 目的 探讨及评价DSA下杂交手术治疗肠系膜上动脉栓塞的疗效及应用前景。 方法 12例急性肠系膜上动脉(SMA)栓塞患者(房颤10例，高血压病1例，无伴随疾病1例)，急诊CTA证实后DSA下杂交手术，包括①SMA导管溶栓、取栓；② SMA经皮球囊扩张成形及内支架置入；③SMA导管溶栓、取栓联合开腹手术。 结果 12例患者均成功取出栓子，栓塞动脉再通，肠管血运可。其中①SMA导管溶栓、取栓6例；②PTA及内支架置入1例；③SMA导管溶栓、取栓联合开腹手术5例。10例患者治愈出院，2例术后24h死亡。 结论 DSA下杂交手术治疗肠系膜上动脉栓塞是一种新型、综合的治疗方法，能融合各种手术方式的优点，克服其缺点。
[关键词] 肠系膜上动脉栓塞；介入；杂交手术;数字减影血管造影
[中图分类号] R657.2 [文献标识码] B [文章编号] 1673-9701(2011) 33-142-02
Hybrid Surgical Treatment under Digital Subtraction Angiograpy(DSA)for Acute Superior Mesenteric Artery Embolism
WANG Di LANG Dehai HU Ming HU Songjie
Department of Vascular Surgery，the Second Hospital of Ningbo City in Zhejiang Province, Ningbo315010, China
[Abstract] Objective To explore and evaluate the effect and application prospect of Hybrid surgical treatment under DSA for acute superior mesenteric artery(SMA) embolism. Methods Twelve cases ( atrial fibrillation in 10 cases;hypertension in 1case; no associated disease, 1 case) of SMAE were treated with hybrid surgical operation under emergency DSA after CTA confirmed,including: ①SMA catheter thrombolysis, embolectomy；② by the SMA balloon angioplasty and stent placement；③ SMA catheter thrombolysis, thrombectomy combined laparotomy. Results Twelve patients were successfully removed emboli, embolism arterial recanalization, intestinal blood flow can be. Which ①SMA catheter thrombolysis, thrombectomy in 6 cases; ②PTA and stent in 1 case; ③SMA catheter thrombolysis, thrombectomy combined laparotomy in 5 cases. 10 patients were cured, 2 patients died after 24h. Conclusion Hybrid surgical operation under DSA for SMAE is a new, comprehensive treatment approach that can blend the advantages of a variety of surgical procedures to address its shortcomings.
[Key words] Superior mesenteric artery embolism(SMAE)；Intervention；Hybrid surgical operation；Digital subtraction angiograpy
肠系膜上动脉栓塞(Superior Mesenteric Arterial Embolism，SMAE)指肠系膜上动脉(Superior Mesenteric Arterial，SMA)突然阻塞致血运障碍,引起肠壁营养障碍的综合征，临床少见但预后极为凶险。文献报道,本病误诊率高达90%～95%,死亡率60%～100%[1]。早期诊断、早期治疗是提高本病治愈率、 降低死亡率、提高生活质量的关键。我们收集了2008年2月～2010年12 月12例SMAE,采用数字减影血管造影(digital subtraction angiograpy,DSA)下杂交手术治疗 ......
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