Analysis Of Prognostic Factors Of Acute Mesenteric Ischemia

Objective:To investigate the clinical characteristics of patients with acute mesenteric ischemia(AMI)and the risk factors affecting the prognosis of patients with acute mesenteric ischemia,and to provide theoretical basis for improving the prognosis of acute mesenteric ischemia.Methods:A retrospective study was conducted to select 73 cases of AMI diagnosed and hospitalized in the first affiliated hospital of xinjiang medical university from October 2014 to October 2018.Clinical data,treatment methods and outcomes were recorded to compare the differences among patients with different prognosis and analyze the factors that may affect the outcomes of patients.Results:73patients with acute mesenteric ischemic disease were included in this study.age(56.25±13.34)years old,male: 41 cases(56.2%),female: 32 cases(43.8%),Discharge:59 cases were improved and 14 cases died.73 AMI patients were divided into the death group(14 cases)and the survival group(59 cases)according to the discharge status.25 patients underwent surgical treatment,and 7 patients died within 30 days after surgery,with a mortality rate of 28%.48 patients underwent conservative treatment,and 7 patients died,with a mortality rate of 14.6%.The causes of death were all multiple organ failure.All the 25 patients underwent intestinal resection,and postoperative pathological examination indicated intestinal necrosis.There were 8 cases(32.0%)of one-stage intestinal anastomosis,and 3 cases(37.5%)died within 30 days after operation.Enterostomy was performed in 17 cases(68%),and 4 cases(23.5%)died within 30 days.Conclusion:Mesenteric ischemic disease is characterized by occult,misdiagnosis and missed diagnosis.CT angiography is still the main method for the diagnosis of such diseases.Although the current routine laboratory examination has no diagnostic value,it has certain guiding significance for the severity or outcome of the disease.Advanced age,low systolic blood pressure,D-Dimer,and high lactic acid were independent predictors ofdeath in AMI patients during hospitalization,which could coordinate with higher shock index.Combined with organ failure and peritoneal effusion,risk stratification can be performed in patients with with acute mesenteric ischemia.