腸繫膜缺血

英文原文:https://en.wikipedia.org/wiki/Mesenteric_ischemia

Mesenteric ischemia is a medical condition in which injury of the small intestine(小肠) occurs due to not enough blood(血液) supply.[1] It can come on suddenly, known as acute mesenteric ischemia, or gradually, known as chronic mesenteric ischemia.[2] Acute disease often presents with sudden severe pain.[2] Symptoms may come on more slowly in those with acute on chronic disease.[1] Signs and symptoms of chronic disease include abdominal pain(腹痛) after eating, unintentional weight loss(减肥), vomiting(呕吐), and being afraid of eating.[1][2]

腸繫膜缺血是因[[血供]]不足而造成的臨床症狀,可致[[小腸]]損傷[1]。腸繫膜缺血病情可發展迅速,即急性腸繫膜缺血;或緩慢,稱為慢性腸繫膜缺血[2]。急性腸繫膜缺血發病常伴有突然的劇烈痛[2]。慢性腸繫膜缺血急性發作時,症狀常出現的較為緩慢[1]。慢性腸繫膜缺血的臨床症狀與體徵包括飯後[[腹痛]]、[[體重減輕]]、[[嘔吐]]以及[[厭食感]][1][2]。

Risk factors include atrial fibrillation(心房顫動), heart failure(心臟衰竭),chronic renal failure(慢性肾脏病), being prone to forming blood clots, and previous myocardial infarction(心肌梗死).[1] There are four mechanisms by which poor blood flow occurs: a blood clot from elsewhere getting lodged in an artery, a new blood clot forming in an artery(血栓形成), a blood clot forming in the mesenteric vein, and insufficient blood flow due to low blood pressure(低血壓) or spasms of arteries(血管收縮).[3][4]Chronic disease is a risk factor for acute disease.[5] The best method of diagnosis is angiography(血管攝影), with computer tomography(X射线计算机断层成像) (CT) being used when that is not available.[2]

腸繫膜缺血的風險因子包括[[心房顫動]]、[[心臟衰竭]]、[[慢性腎臟病]]、[[易栓症]],以及[[心肌梗塞]]病史[1]。有四種發病機制可致血供不足,包括:脫落的血栓[[阻塞動脈]]、腸繫膜動脈[[形成血栓]]、[[腸繫膜靜脈]]形成血栓、以及由於[[低血壓]]或[[血管收縮]]導致血量不足[3][4]。慢性腸繫膜缺血也是急性發作的風險因子[5]。診斷腸繫膜缺血的首選辦法是採用[[血管造影]],[[X射線計算機斷層成像|CT]]可作為其替代辦法[2]。

Treatment of acute ischemia may include stenting(支架) or medications to break down the clot provided at the site of obstruction byinterventional radiology.[2] Open surgery(微創手術) may also be used to remove or bypass the obstruction and may be required to remove any intestines that may have died.[1] If not rapidly treated outcomes are often poor.[2] Among those affected even with treatment the risk of death is 70% to 90%.[3] In those with chronic disease bypass surgery is the treatment of choice.[2] Those who have thrombosis of the vein may be treated with anticoagulation(抗凝剂) such as heparin(肝素) andwarfarin(华法林), with surgery used if they do not improve.[1][6]

Acute mesenteric ischemia affects about five per hundred thousand people per year in the developed world.[7] Chronic mesenteric ischemia affects about one per hundred thousand people.[8]Most people affected are over 60 years old.[3] Rates are about equal in males and females of the same age.[3] Mesenteric ischemia was first described in 1895.[2]

在巳開發國家中,每一百人中約有五人罹患急性腸繫膜缺血[7],有一人罹患慢性腸繫繫膜缺血[8]。大部份得到腸繫膜缺血的人都是在60歲以上[3]。同年齡男性和女性的罹患