腸係膜缺血

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

中文: 尚無

This article concerns ischemia of the small bowel. See ischemic colitis for ischemia of the large bowel

本文敘述的[[缺血症狀]]發生於小腸。大腸的缺血情況請見[[缺血性結腸炎]]。

Mesenteric ischemia is a medical condition in which injury of the small intestine occurs due to not enough blood 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 after eating, unintentional weight loss, vomiting, and being afraid of eating.^[1][2]

’’’腸係膜缺血’’’是描述因血液供應不足而造成的[[小腸]]損傷的情形[1]。腸係膜缺血可分為急性及慢性[2]。急性發病的常見症狀為突然劇痛[2]。患有慢性腸繫膜缺血的患者的急性發作，相較沒有慢性腸繫膜缺血的患者，其症狀出現較為緩慢[1]。慢性發病的特徵與症狀包括飯後[[腹痛]]，[[無意性的減重]]，[[嘔吐]]和害怕進食[1][2]。

Risk factors include atrial fibrillation, heart failure, chronic renal failure, being prone to forming blood clots, and previous myocardial infarction.^[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, a blood clot forming in the mesenteric vein, and insufficient blood flow due tolow blood pressure or spasms of arteries.^[3][4] Chronic disease is a risk factor for acute disease.^[5] The best method of diagnosis is angiography, with computer tomography (CT) being used when that is not available.^[2]

腸係膜缺血的風險因子包括：[[心房震顫]]、[[心臟衰竭]]、[[慢性腎衰竭]]、[[先天性血栓形成體質]]，以及[[心肌梗塞]]病史[1]。血液供應不足可藉由四種機制發生：[[動脈栓塞]]（他處血栓堵住血管）、[[動脈內的血栓形成]]、[[腸繫膜靜脈]]內的血栓形成，以及由於[[低血壓]]或[[血管收縮]]造成的血流不足[3][4]。慢性腸繫膜缺血也是其其急性發作的風險因子之一[5]。[[血管造影]]是診斷腸繫膜缺血的金標準，而[[電腦斷層掃描(CT)]]也可作為其診斷的替代方法[2]。

Treatment of acute ischemia may include stenting or medications to break down the clot provided at the site of obstruction by interventional radiology.^[2] Open surgery 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 such as heparin and warfarin, with surgery used if they do not improve.^[1][6]

急性腸係膜缺血的治療，可利用[[介入放射學]]在找到的阻塞處使用支架置入術或[[溶栓藥物]][2]。[[開放手術]]也可用於移除阻塞或架設旁路，並且可用來移除可能壞死的腸道[1]。若缺少迅速的治療，急性腸係膜缺血的預後非常差[2]。病人即使受到治療，其死亡風險為70%到90%[3]。對於慢性腸繫膜缺血患者，可選擇[[血管繞道手術]]治療[2]。對於發生靜脈栓塞的患者，可採用[[抗凝治療]]，例如使用[[肝素(heparin)]]或[[華法林(warfarin)]]；在藥物治療無改善時刻需考慮手術治療[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]

在發達國家中，大約每十萬人就有五人受到急性腸係膜缺血影響[7]。而大約每十萬人中有一個人會受到慢性腸係膜缺血影響[8]。受到影響的人大部分超過60歲[3]。同年齡層的男性與女性比例相同[3]。腸係膜缺血最早於1895年被現代醫學記載[2]。

References
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