提高缺血性肠病的临床认识

缺血性肠病是一组因小肠、结肠血液供应不足导致的不同程度的肠壁局部组织坏死和一系列症状的疾病，可分为急性肠系膜缺血（AMI）、慢性肠系膜缺血（CMI）及缺血性结肠炎（IC），以IC最多见。临床表现主要为腹痛、血性腹泻、血便及腹胀等消化道症状。该病与动脉粥样硬化、肠系膜动静脉栓塞及血栓形成、心搏量减少及血管炎等有关，患者可同时存在高血压、糖尿病及急性心肌梗死等老龄化疾病。DSA及CT检查对于诊断AMI及CMI价值较高，而IC则主要依赖于结肠镜的诊断。预后也各不相同，AMI病情凶险，死亡率高，须早期诊断及手术治疗；而IC临床症状多为自限性，预后良好。缺血性肠病临床误诊率较高，应引起临床医师重视。

To strengthen the clinical recognition of ischemic bowel diseases

Ischemic bowel diseases are caused by acute or chronic insufficiency of blood flow to all or part of the gastrointestinal tract,especially involve small intestine and colon,usually include acute mesenteric ischemia(AMI),chronic mesenteric ischemia(CMI) and ischemic colitis(IC).IC is the most common form.Dominant presenting symptoms are abdominal pain,bloody diarrhea,hematochezia,bloating.The diseases are mainly caused by atherosclerosis,embolism or thrombosis of the mesenteric vessel,decreased cardiac outpu...