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- W2943154964 abstract "Objective To investigate the optimal treatment strategy of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and the effect of anticoagulation therapy on the prognosis of SIDSMA. Methods The clinical data of 29 patients presented with acute or subacute mesenteric ischemia (a history of less than 14 days) due to SIDSMA admitted to the Department of Vascular Surgery of Peking Union Medical College Hospital from January 1st 2003 to December 31th 2016 were retrospectively analyzed. Results In this study,28 cases were male and the remaining one was female,with an average age of (49.1±7.6) years. The emergency endovascular treatment were performed on 4 cases with severe mesenteric intestinal ischemia,and the symptoms were relieved postoperatively. The remaining 25 cases were treated with conservative treatment. Among 13 cases who were received adequate anticoagulantion therapy,symptoms were relieved or disappeared in 9 cases (69.2%),whereas conservative treatment was ineffective in 4 cases (30.8%),for whom surgical intervention were performed. Among 12 cases who received conservative treatment without sufficient anticoagulation,the abdominal pain was relieved in only 2 cases (16.7%) and the remaining 10 cases (83.3%) were converted to surgical intervention. The success rate of conservative treatment for patients with adequate anticoagulant therapy was significantly higher than that of patients who had not received adequate anticoagulant therapy (P=0.015). Conclusions Adequate anticoagulation therapy has good therapeutic effect in most SIDSMA cases with acute or subacute mesenteric ischemia. For patients with severe mesenteric ischemia or those fail to respond to initial conservative treatment,endovascular treatment may be a more reasonable option.目的 探讨孤立性肠系膜上动脉夹层(SIDSMA)的最佳治疗策略以及保守治疗过程中抗凝药物对SIDSMA预后的影响。方法 回顾性分析2003年1月1日至2016年12月31日在北京协和医院血管外科收治的29例因急性或亚急性肠系膜缺血症状(病史≤14 d)就诊的SIDSMA患者的病史资料及随访结果。结果 29例患者中,4例肠缺血严重,紧急行肠系膜上动脉支架置入术,术后症状缓解。25例首选保守治疗,其中得到有效抗凝治疗的13例患者中,有9例(69.2%)症状明显缓解或消失,避免了外科干预;4例(30.8%)保守治疗效果不佳,转外科干预获得成功。在保守治疗过程中未获得有效抗凝治疗的12例患者中,只有2例(16.7%)经保守治疗后腹痛缓解,其余10例(83.3%)患者腹痛症状无缓解而转血管腔内治疗。采取有效抗凝治疗患者的保守治疗成功率明显高于未获得有效抗凝治疗的患者(P=0.015)。结论 对于SIDSMA引起的急性或亚急性肠系膜缺血,有效抗凝治疗可以达到较好的治疗效果;而对于急性重症肠缺血或抗凝治疗无效的患者,腔内治疗是有效的外科干预措施。." @default.
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- W2943154964 date "2018-02-28" @default.
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- W2943154964 title "Effect of Adequate Anticoagulantion Therapy on the Outcome of Spontaneous Isolated Dissection of Superior Mesenteric Artery." @default.
- W2943154964 doi "https://doi.org/10.3881/j.issn.1000-503x.2018.01.004" @default.
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