中国医学科学院学报2018，Vol.40Issue(1)：21-25,5.DOI:10.3881/j.issn.1000-503X.2018.01.004
抗凝治疗对孤立性肠系膜上动脉夹层转归的影响
Effect of Adequate Anticoagulantion Therapy on the Outcome of Spontaneous Isolated Dissection of Superior Mesenteric Artery
刘琦 1李天佳 1曾嵘 1陈跃鑫 1叶炜 1刘暴 1刘昌伟1
作者信息
- 1. 中国医学科学院北京协和医学院北京协和医院血管外科,北京100730
- 折叠
摘要
Abstract
Objective To investigate the optimal treatment strategy of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and the effect of anticoagulation therapy on the prognosis of SIDSMA.Methods The clinical data of 29 patients presented with acute or subacute mesenteric ischemia (a history of less than 14 days) due to SIDSMA admitted to the Department of Vascular Surgery of Peking Union Medical College Hospital from January 1 st 2003 to December 31 th 2016 were retrospectively analyzed.Results In this study,28cases were male and the remaining one was female,with an average age of (49.1 ± 7.6) years.The emergency endovascular treatment were performed on 4 cases with severe mesenteric intestinal ischemia,and the symptoms were relieved postoperatively.The remaining 25 cases were treated with conservative treatment.Among 13 caseswho were received adequate anticoagulantion therapy,symptoms were relieved or disappeared in 9 cases (69.2％),whereas conservative treatment was ineffective in 4 cases (30.8％),for whom surgical intervention were performed.Among 12 cases who received conservative treatment without sufficient anticoagulation,the abdominal pain was relieved in only 2 cases (16.7％) and the remaining 10 cases (83.3％) were converted to surgical intervention.The success rate of conservative treatment for patients with adequate anticoagulant therapy was significantly higher than that of patients who had not received adequate anticoagulant therapy (P =0.015).Conclusions Adequate anticoagulation therapy has good therapeutic effect in most SIDSMA cases with acute or subacute mesenteric ischemia.For patients with severe mesenteric ischemia or those fail to respond to initial conservative treatment,endovascular treatment may be a more reasonable option.关键词
肠系膜上动脉/夹层/急性肠系膜缺血/抗凝/支架Key words
superior mesenteric artery/dissection/acute mesenteric ischemia/anticoagulation/stent分类
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刘琦,李天佳,曾嵘,陈跃鑫,叶炜,刘暴,刘昌伟..抗凝治疗对孤立性肠系膜上动脉夹层转归的影响[J].中国医学科学院学报,2018,40(1):21-25,5.
