急性肠系膜血管闭塞诊治情况分析

目的 分析急性肠系膜血管闭塞(AMVO)的临床表现、诊断和治疗。方法 对解放军总医院20例及文献报道多家医院的92例AMVO患者，共112例进行综合分析。结果 AMVO临床表现中腹痛、腹胀、恶心呕吐、肠鸣音减弱或消失、白细胞升高等出现频率较高，既往史中多有心血管疾病、门静脉系统血流淤滞或血液高凝状态等。全组平均误诊率为61．5％，其中本院20例误诊率为45．0％。全组平均死亡率为41．9％，其中本院20例死亡率为30．0％。结论 急性肠系膜血管闭塞早期临床表现缺乏特异性，误诊率及死亡率高。对于可疑病例，应尽早行血管造影以明确诊断，提高疗效。

Analysis of diagnosis and treatment of acute mesenteric vascular obliteration

Objective To analyze the clinical manifestation, diagnosis and treatment of acute mesenteric vascular obliteration (AMVO). Methods 112 cases of AMVO were analyzed, including 20 cases admitted to our hospital from 1992 to 2004 and 92 cases reported by other hospitals. Results Abdominal pain, abdominal distension, nausea and vomiting, decrease or disappearance of bowel sound, elevation of white blood cell count were more frequent manifestations.Cardiovascular disease, portal vein stasis or hypercoagulation state were common findings in patients' history. The average misdiagnosis rate of AMVO in these 112 patients was 61.5%, with a misdiagnosis rate of 45.0% in 20 cases of our hospital. The average mortality rate of all these patients was 41.9%, with a mortality rate of 30.0% for 20 cases of our hospital. Conclusion The early clinical manifestation of AMVO lacks specificity, the misdiagnosis ratio and mortality rate are very high. Angiography should be done early to confirm the diagnosis and improve the therapeutic effect in the patients suspicions of having this ailment.