燒傷并發(fā)腸系膜上動脈綜合征臨床報告

摘要： 目的探討腸系膜上動脈綜合征的臨床特點和治療方法。方法對以往所治療的燒傷并發(fā)腸系膜上動脈綜合征的病歷資料進行歸納分析,總結他們共同的臨床表現、治療方法和臨床療效。結果 5例患者均被治愈,他們的燒傷總面積均值為65.44%TBSA±27.26%TBSA,傷后平均發(fā)病時間為22.8 d±10.55 d,主要發(fā)病因素為長期臥床、全身性營養(yǎng)不良、身體消瘦,臨床表現為上腹部飽脹,反復出現無痛性嘔吐,進食后癥狀加重,每日嘔吐物少則數百毫升,多則在2000 ml以上,為綠色或深綠包,無血跡,鋇餐透視表現:胃十二指腸膨大,十二指腸第4段出現不全性梗阻。結論燒傷并發(fā)腸系膜上動脈綜合征的誘因未必都是大面積深度燒傷,內科保守療法應是首選治療方法 ,銅球鼻飼管道通過梗阻部位進行腸內營養(yǎng),有助于能量補充和疾病恢復。
Objective Explore the clinical characteristics and treatment measures of superior mesenteric artery syndrome. Methods Summarize the common clinical signs,treatment measures and clinical efficacy by collecting and analyzing clinical data of burn complicated by superior mesenteric artery syndrome in the past.Results The 5 patients were all cured, and the average burn area was 65.44%TBSA±27.26%TBSA,average time of onset being 22.8 d±10.55d;the primary causes of onset were long term lieing in bed,systemic malnutrition and thinness;clinical signs were epigastric satiely,recurrent painless vomiting,worse after eating,amount of vomitus around hundreds ml or over 2000ml per day,usually green or dark green without blood stains.Signs from barium swallow showed gastro—duodenal expansion,incomplete obstruction at the 4~(th) segment of duodenum.Conclusion Mesenteric artery syndrome is not always resulted from large intensive burns;priority regimen is conservative treatment.Enteral feeding by Miller—tube provides nutrition and contributes to recovery.