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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。
Objective: To investigate the clinical manifestations and outcome of intestinal necrosis caused by non-occlusive mesenteric ischemia. Methods: 11 cases of non-occlusive mesenteric ischemia-induced intestinal necrosis in Affiliated Hospital of Qingdao University were retrospectively reviewed. Their clinical manifestations, laboratory tests, abdominal CT and surgical procedures were evaluated. RESULTS: All patients underwent laparotomy under general anesthesia. The patients underwent gastrectomy and one-stage anastomosis or enterostomy. Seven patients recovered well, two died during hospitalization and two died after returning home. Conclusion: Noninvasive mesenteric ischemia is rare and difficult to diagnose before operation. It has high mortality and angiography can be used as an effective method for early diagnosis and treatment of NOMI. Surgical treatment of patients with suspected intestinal necrosis is required.