缺血性肠病34例临床分析-肿瘤学(胃肠外科)专业毕业论文.pdfVIP

缺血性肠病34 例临床分析 中文摘要 目的：了解缺血性肠病发病的基本临床特征，总结对本病诊断及临床外科治疗的经验， 提高胃肠外科医师对本疾病诊断和治疗的认识。方法：收集福建医科大学附属第一医 院外科2006 年2 月至2010 年 12 月救治的34 例缺血性肠病的临床病例。回顾性分析 患者伴随的基础疾病、临床症状、辅助检查结果、治疗经过及预后等。结果：本组病 例34 例，病变发生于小肠者8 例，结肠者26 例。出现腹痛症状者91.2% （31/34）； 出现便血症状者85.3% （29/34），出现腹膜刺激征者52.9% （18/34）。行彩色多普勒 超声检查 13 例，有阳性提示9 例；行CT 检查26 例，均有阳性提示，17 例确诊为肠 系膜血管血栓或栓塞；行DSA 检查 4 例，均确诊为肠系膜血管血栓或栓塞。8 例患者 保守治疗后病情好转出院，26 例患者行手术治疗，死亡3 例，死亡率8.8%。结论：缺 血性肠病无特异性的临床特征，漏诊及误诊率较高，对于不明原因出现腹痛、血便或 腹膜刺激征的中老年人应考虑缺血性肠病的可能，充分运用相关辅助检查，以明确诊 断；早期诊断、早期治疗、准确把握手术时机是降低缺血性肠病病死率的关键。 关键词：缺血性肠病 肠系膜血管病 综合治疗 手术 4 Clinical Analysis of 34 Patients with Ischemic Bowel Disease Abstract Objective: To learn this disease clinical characteristic.And get the method for this disease diagnosis and operation treatment and to find better way for its diagnosis and opration treatment for gestrointestinal surgeon.Methods:Clinical data of 34 patients with the diagnosis of ischemic bowel disease of from the first affiliated hospital of FUJIAN medical university department of surgery from February 2006 to December 2010. Retrospective analysis of patients with basic diseases,clinical symptoms,auxiliary examination results,treatment and prognosis Result: 34 patients lesions occurred in the small intestine in 8 cases,26 cases of colon. Thirty-one patients presented symptom of abdominal pain,52.9%(18/34)had Peritoneal irritation sign.Examination of color Doppler ultrasound in 13cases,positive Tip 9 cases;CT checks 26 patients,there is positive suggestion 17 patients are made a definite diagnosis of intestinal membranes vascular thrombosis or embolism;DSA 4 cases were confirmed mesenteric vascular thrombosis or embolism.Conservative treatment of 8 patients condition improves after discharge from hospital,26 patients underwent surgery,3 d