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題名 | Acute Mesenteric Ischemia=急性腸繫膜缺血 |
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作者 | 黃鴻安; 莫景棠; 劉絮穎; 張宏泰; 周楠華; 蔡正中; 王炳惠; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 30:2 民86.03-04 |
頁次 | 頁103-110 |
分類號 | 416.245 |
關鍵詞 | 急性腸繫膜缺血; Mesenteric ischemia; |
語文 | 英文(English) |
中文摘要 | 自1990年10月至1996年3月,共有34例急性腸繫膜缺血病人在本院接受治療。其中 有男性 29 例,女性 5 例,年齡分布自 42 歲至 88 歲,平均 71 歲。 除壹例是經由血管 攝影診斷外,其餘皆由剖腹探查證實,這種病好發於老年人合併有心臟病史,或有周邊動脈 硬化症狀,或有門脈高壓,或先經歷休克再腹部不舒服者。臨床表現特徵句括百分之七十四 病人有腹痛,百分之六十二有腹膜炎症狀,百分之五十六有術前休克,百分之五十三有代謝 性酸中毒。經由血管攝影診斷個例,未經手術治療而痊癒。其餘 33 例接受手術治療。其中 7 例僅接受剖腹探查,25 例接受部分腸切除,1 例接受暢通血流手術, 合計有百分之七十 四死亡率。手術前有休克或代謝性酸中毒者,預後較差。廣泛應用緊急血管攝影來作早期診 斷,加上暢通血流手術,是未來提升治療成效的希望。 |
英文摘要 | From October 1990 to March 1996, 34 patients with acute mesenteric ischemia were treated at the Veterans General Hospital-Kaohsiung. Among them were 29 males and 5 females whose mean age was 71 years, with a range of 42-88 years. Except for one case diagnosed by angiography, the diagnosis was verified in all cases by laparotomy. The risk factors included old age in with previous heart disease, symptoms of peripheral atherosclerosis, portal hypertension, and experience of hypotension before abdominal discomfort. presenting clinical features consisted of abdominal pain (74 percent), peritonitis (62 percent), shock (56 percent), and metabolic acidosis (53 percent). The disease was diagnosed by angiography in one patient, who recovered without surgical intervention. The other 33 patients were treated surgically: Seven underwent exploratory laparotomy, 25 underwent bowel resection, and 1 underwent revascularization. The overall mortality was 74 ﹪. Patients with preoperative shock or acidosis had a poor prognosis. Earlier diagnosis by more widespread use of emergency angiography, coupled by revascularization procedures should offer the best chance for future improvement. |
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