烧伤并发肠系膜上动脉综合征临床报告

目的 探讨肠系膜上动脉综合征的临床特点和治疗方法.方法 对以往所治疗的烧伤并发肠系膜上动脉综合征的病历资料进行归纳分析,总结他们共同的临床表现、治疗方法和临床疗效.结果 5例患者均被治愈,他们的烧伤总面积均值为65.44％ TBSA±27.26％ TBSA,伤后平均发病时间为22.8 d±10.55 d,主要发病因素为长期卧床、全身性营养不良、身体消瘦,临床表现为上腹部饱胀,反复出现无痛性呕吐,进食后症状加重,每日呕吐物少则数百毫升,多则在2000 ml以上,为绿色或深绿色,无血迹.钡餐透视表现:胃十二指肠膨大,十二指肠第4段出现不全性梗阻.结论 烧伤并发肠系膜上动脉综合征的诱因未必都是大面积深度烧伤,内科保守疗法应是首选治疗方法,铜球鼻饲管道通过梗阻部位进行肠内营养,有助于能量补充和疾病恢复.

Clinical Report of Burns Complicated by Superior Mesenteric Artery Syndrome

Objective Explore the clinical eharacteristies and treatment measures of superior mesenterie arlery syH- drome. Methods Summarize the common clinical signs, treatment measures and clinical efficacy by collecting and analyzing clinical data of burn complicated by superior mesenteric artery syndrome in the past. Results The 5 patients were all cure.d, and the average burn area was 65.44% TBSA±27.26% TBSA, average time of onset being 22. 8 d±10. 55 d; the primary causes of onset were long term lieing in bed, systemic malnutrition and thinness; elinleal signs were epigastric satiety, recur- rent painless vomiting, worse ＇after eating, amount of＂ vomitus around hundreds nil or over 200Oral per day, usually greetl or dark green without blood stains. Sigus from barium swallow showed gastro-duodenal expansion, incomplete obstructiou at the 4^th segment of duodenum. Conclusion Mesenteric artery syndrome is not always resulted from large intensive burns; priority regimen is conservative treatment. Euteral feeding by Miller-tube provides nutrition and contributes to recovery.