Diagnosis And Treatment Of35Cases Of Acute Mesenteric Ischemia Disease

Objective:Analysis35acute mesenteric ischemia disease clinical data of ourhospital in recent years to investigate the acute mesenteric ischemia diseasepathogenesis, clinical diagnosis and treatment to improve the understanding of thediagnosis and treatment of this disease.Methods:Cases of35acute mesenteric ischemia disease in our hospital fromFebruary2004to November2012,was collected to retrospective analyze theirunderlying diseases, clinical characteristics, diagnosis and treatment.Results:In35patients, male20cases, female15cases, the ratio of male to femalewas4:3; the average age is67.31years old. Previous cardiac history accounted for20cases (57.14%), history of hypertension in15cases (42.86%),8cases of diabetesmellitus (22.86%),4cases of history of cerebral thrombosis (11.42%),3cases ofabdominal operation history (8.57%),2cases of lacunar infarction (5.71%).35patientspresented with abdominal pain, abdominal distension, of which16cases accompaniedby nausea, vomiting;7cases appear blood. Abdominal examination,29cases foundtenderness, bowel sounds less4cases,7cases of peritoneal irritation.Auxiliaryexamination, elevated white blood cell count in23cases, accounting for65.71%.Abdominal B ultrasound in7cases,2cases were diagnosed.10cases of abdominalX-ray examination,18cases underwent CT, including7cases of CTA examination. Fordigital subtraction angiography (DSA) in3cases of inspection, MRI of0cases.Recordsof12cases of misdiagnosed, the misdiagnosis rate was34.28%. The treatment of nonoperation therapy, interventional therapy, operation therapy. The conservative treatment12cases, interventional therapy in3cases,20cases were treated with operation,including13cases of intestinal resection,2underwent thrombectomy, and respectivelywith bowel resection, decompression of intestine, small intestine and colon resection in2cases,3cases of abdominal switch, soon died after operation.7patients died after operation, postoperative mortality was35%. In35patients,20cases were cured anddischarged, the cure rate was57.14%,15cases died, the mortality was42.86%.Conclusions:1.AMI belongs to the rare acute abdominal disease, illnessdevelopment is rapid, the diagnosis is difficult, the misdiagnosis rate is high, easy todelay the timing of treatment, and with high mortality.2.Due to the lack of specificity of clinical manifestations of AMI,when the painand abdominal signs do not match,and with high risk factors of the disease,this diseaseshould be taken into account in time,and CTA and DSA examination should be carriedout.3According to the disease stage of development, to conservative treatment,effective interventional therapy and operation therapy, early solve mesenteric ischemiacondition, can increase the survival rate of the patients.