DsA下杂交手术治疗肠系膜上动脉栓塞

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；②SMA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。

Hybrid Surgical Treatment under Digital Subtraction Angiograpy (DSA) for Acute Superior Mesenteric Artery Embolism

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 lcase; no associated disease, 1 case ） of SMAE were treated with hybrid surgical operation under emergency DSA after CTA confirmed,including： ①SMA catheter thrombolysis, embolectomy; ②by the SMA balloon angioplasty and stent placement; ③ SMA catheter thrombolysis, thrombectomy combined laparotomy. Results Twelve patients were successfully removed emboli, embolism arterial recanalization, intestinM blood flow can be. Which ④SMA catheter thrombolysis, thrombectomy in 6 cases; ⑥ PTA and stent in 1 case;⑤SMA 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.