腸係膜缺血
編輯歷史
| 時間 | 作者 | 版本 |
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| 2017-07-17 16:40 – 16:40 | r0 – r1 | |
顯示 diff+ 腸係膜缺血
+ 英文: https://en.wikipedia.org/wiki/Mesenteric_ischemia
+ 中文: 尚無
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+ 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]]。
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+ 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]。
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+ 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]。
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+ 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]
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+ 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]。
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+ 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]。
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+ *References
+ *1. a b c d e f Yelon, Jay A. (2014). Geriatric Trauma and Critical Care (Aufl. 2014 ed.). New York: Springer Verlag. p. 182. ISBN 9781461485018.
+ *2. a b c d e f g h i j Bobadilla, JL (August 2013). "Mesenteric ischemia.". The Surgical clinics of North America. 93 (4): 925–40, ix. doi:10.1016/j.suc.2013.04.002.PMID 23885938.
+ *3. a b c d Britt, L.D. (2012). Acute care surgery (1st ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 621. ISBN 9781608314287.
+ *4. Creager, Mark A. (2013). Vascular medicine : a companion to Braunwald's heart disease (2nd ed.). Philadelphia, PA: Elsevier/Saunders. pp. 323–324.ISBN 9781437729306.
+ *5. Sreenarasimhaiah, J (April 2005). "Chronic mesenteric ischemia.". Best practice & research. Clinical gastroenterology. 19 (2): 283–95. doi:10.1016/j.bpg.2004.11.002.PMID 15833694.
+ *6. Liapis, C.D. (2007). Vascular surgery. Berlin: Springer. p. 420. ISBN 9783540309567.
+ *7. Geoffrey D. Rubin (2012). CT and MR Angiography: Comprehensive Vascular Assessment. Lippincott Williams & Wilkins. p. 318. ISBN 9781469801834.
+ *8. Gustavo S. Oderich (2014). Mesenteric Vascular Disease: Current Therapy. Springer. p. 105. ISBN 9781493918478.
+ *9. Boley, SJ, Brandt, LJ, Veith, FJ (1978). "Ischemic disorders of the intestines". Curr Probl Surg. 15 (4): 1–85. doi:10.1016/S0011-3840(78)80018-5. PMID 365467.
+ *10. Hunter G, Guernsey J (1988). "Mesenteric ischemia". Med Clin North Am. 72 (5): 1091–115. PMID 3045452.
+ *11. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD (2004). "Acute mesenteric ischemia: a clinical review". Arch. Intern. Med. 164 (10): 1054–62.doi:10.1001/archinte.164.10.1054. PMID 15159262.
+ *12. Font VE, Hermann RE, Longworth DL (1989). "Chronic mesenteric venous thrombosis: difficult diagnosis and therapy". Cleveland Clinic journal of medicine. 56 (8): 823–8.doi:10.3949/ccjm.56.8.823. PMID 2691119.
+ *13. Levy PJ, Krausz MM, Manny J (1990). "Acute mesenteric ischemia: improved results--a retrospective analysis of ninety-two patients". Surgery. 107 (4): 372–80. PMID 2321134.
+ *14. a b c Park WM, Gloviczki P, Cherry KJ, Hallett JW, Bower TC, Panneton JM, Schleck C,Ilstrup D, Harmsen WS, Noel AA (2002). "Contemporary management of acute mesenteric ischemia: Factors associated with survival". J. Vasc. Surg. 35 (3): 445–52.doi:10.1067/mva.2002.120373. PMID 11877691.
+ *15. "American Gastroenterological Association Medical Position Statement: guidelines on intestinal ischemia.". Gastroenterology. 118 (5): 951–3. May 2000. doi:10.1016/s0016-5085(00)70182-x. PMID 10784595.
+ *16. a b c Cope, Zachary; Silen, William (April 2005). Cope's Early Diagnosis of the Acute Abdomen (21st ed.). New York: Oxford University Press. ISBN 978-0-19-517545-5.LCCN 2004058138. OCLC 56324163.
+ *17. Evennett NJ, Petrov MS, Mittal A, Windsor JA (July 2009). "Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia". World J Surg. 33 (7): 1374–83. doi:10.1007/s00268-009-0074-7. PMID 19424744.
+ *18. Lee ES, Bass A, Arko FR, et al. (2006). "Intraoperative colon mucosal oxygen saturation during aortic surgery". The Journal of surgical research. 136 (1): 19–24.doi:10.1016/j.jss.2006.05.014. PMID 16978651.
+ *19. Friedland S, Benaron D, Coogan S, et al. (2007). "Diagnosis of chronic mesenteric ischemia by visible light spectroscopy during endoscopy". Gastrointest Endosc. 65 (2): 294–300. doi:10.1016/j.gie.2006.05.007. PMID 17137857.
+ *20. Lee ES, Pevec WC, Link DP, et al. (2008). "Use of T-stat to Predict Colonic Ischemia during and after Endovascular Aneurysm Repair: A case report". J Vasc Surg. 47 (3): 632–634. doi:10.1016/j.jvs.2007.09.037. PMC 2707776. PMID 18295116
+ *21. Smerud M, Johnson C, Stephens D (1990). "Diagnosis of bowel infarction: a comparison of plain films and CT scans in 23 cases". AJR Am J Roentgenol. 154 (1): 99–103.doi:10.2214/ajr.154.1.2104734. PMID 2104734.
+ *22. a b c d e Alpern M, Glazer G, Francis I (1988). "Ischemic or infarcted bowel: CT findings". Radiology. 166 (1 Pt 1): 149–52. doi:10.1148/radiology.166.1.3336673.PMID 3336673.
+ *23. Taourel P, Deneuville M, Pradel J, Régent D, Bruel J (1996). "Acute mesenteric ischemia: diagnosis with contrast-enhanced CT" (PDF). Radiology. 199 (3): 632–6.doi:10.1148/radiology.199.3.8637978. PMID 8637978.
+ *24. Staunton M, Malone DE (2005). "Can acute mesenteric ischemia be ruled out using computed tomography? Critically appraised topic |". Canadian Association of Radiologists Journal. 56 (1): 9–12. PMID 15835585.
+ *25. Pereira JM, Sirlin CB, Pinto PS, Jeffrey RB, Stella DL, Casola G (2004). "Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain".Radiographics : a review publication of the Radiological Society of North America, Inc. 24(3): 703–15. doi:10.1148/rg.243035084. PMID 15143223.
+ *26. Kao, Lillian S., and Tammy Lee. PreTest Surgery: PreTest Self-assessment and Review. New York: McGraw-Hill Medical, 2009.
+ *27. Sreenarasimhaiah J (2003). "Diagnosis and management of intestinal ischaemic disorders". BMJ. 326 (7403): 1372–6. doi:10.1136/bmj.326.7403.1372. PMC 1126251. PMID
+ *28. Meng, X; Liu, L; Jiang, H (August 2010). "Indications and procedures for second-look surgery in acute mesenteric ischemia.". Surgery today. 40 (8): 700–5. doi:10.1007/s00595-009-4140-4. PMID 20676851.
+ *29. Brandt, LJ; Boley, SJ (May 2000). "AGA technical review on intestinal ischemia. American Gastrointestinal Association.". Gastroenterology. 118 (5): 954–68. doi:10.1016/s0016-5085(00)70183-1. PMID 10784596.
+ *30. Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM (2004). "Systematic review of survival after acute mesenteric ischaemia according to disease aetiology". The British journal of surgery. 91 (1): 17–27. doi:10.1002/bjs.4459. PMID 14716789.
+ 2016年10月15日 已整合至中文維基
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