文档介绍：42例缺血性肠病临床探讨
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作者:李培亮仝麟龙李红普
【摘要】目的探讨缺血性肠病的临床诊断及治疗,进一步提高对该病的认识。方法收集42例缺血性肠病的临床资料进行回顾性分析。结果 42例患者中,男30例,女12例;10例有高血压病史,16例有冠心病史。CT确诊8例,B超确诊6例,DSA确诊15例。该病临床缺乏特异性,误诊率高。结论缺血性肠病临床症状与体征无特异性,误诊率高,病死率高,对于具有血栓形成或栓子脱落等基础疾病的高龄患者应高度考虑本病。
【关键词】缺血性肠病;肠系膜血管闭塞;手术
【Abstract】 Objective To analyze clinical features and sum up experience of ischemic bowel disease. Methods Clinical data of 42 patients with ischemic bowel disease were retrospectively analyzed. Results Thirty patients were male and twelve were female. Ten patients were panied with hypertension and sixteen had a history of coronary disease. Eight patients were proved by patients were diagnosed by Bultrasonography and fifteen by DSA. Conclusion The clinical manifestation of ischemic bowel disease is less specific. The rates of misdiagnosis and mortality are high. Elder patients, especially with a history of cerebrovascular disease should be considered for the possibility of ischemic
bowel disease.
【Key words】 Ischemic bowel disease; Mesenteric vascular occlusion; Operation
缺血性肠病是20世纪60年代初提出的一组具有一定临床病理特点的独立性疾病,是肠血管功能或形态变化所致的疾病[1]。由于该病临床表现无特异性,早期诊断困难,病死率高达70%~90%。我院1998~2005年共收治缺血性肠病患者42例,临床探讨如下。
1 临床资料
一般资料本组42例中,男30例,女12例。年龄36~78岁。既往有高血压病10例,冠心病16例,糖尿病4例,心瓣膜病8例。同时伴房颤18例,合并脑梗死11例。CT确诊8例,B超确诊6例,DSA确诊15例。
临床表现缺血性肠病具有症状与体征不相符的特征,即腹痛重、体征轻,早期腹肌软,压痛点不固定。本病临床表现分为两个阶