非闭塞性肠系膜缺血致肠坏死的临床分析(附11例报道)

目的:探讨非闭塞性肠系膜缺血所致肠坏死的临床表现和结局。方法:回顾性总结青岛大学附属医院11例非闭塞性肠系膜缺血所致肠坏死的病例,评估分析其临床表现、实验室检查、腹部CT影像和手术过程。结果:所有病人均在全麻下行剖腹探查术,实施肠管切除术并一期吻合术或肠造口术,7例病人恢复良好,2例住院期间死亡,2例放弃治疗回家后死亡。结论:非闭塞性肠系膜缺血临床罕见,术前难以诊断,具有较高的病死率,血管造影可以作为NOMI早期诊断及治疗的有效手段,对于怀疑有肠坏死发生的患者需及早行手术治疗。

Clinical Analysis of Necrotizing Enterocolitis Caused by Non-occlusive Mesenteric Ischemia(Reports of 11 cases)*

Objective： To explore the clinical manifestation and outcome of acute intestinal necrosis caused by non-occlusive mesenteric ischemia（NOMI）. Methods： Retrospective case record reviews of 11 patients who suffered from necrotizing enterocolitis cause by NOMI in the Affiliated Hospital of Qingdao University were undertaken. The clinical manifestation, laboratory findings, abdominal CT imaging and surgical procedures were evaluated and analyzed. Results： All patients underwent exploratory laparotomy under general anesthesia. Bowel resection with primary anastomosis or enterostomy was performed. 7 patients had a good recovery, while 2 patients died during hospital stay and 2 patients died at home due to abandoning treatment. Conclusion： NOMI was a rare condition which was difficult to diagnose preoperatively and had a high mortality rate. Angiography could be used as an effective method for the early diagno-sis and treatment of NOMI. Early surgical intervention should be considered in case of suspected bowel necrosis.