中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2011年
9期
728-728
,共1页
上肠系膜动脉综合征%诊断%外科手术
上腸繫膜動脈綜閤徵%診斷%外科手術
상장계막동맥종합정%진단%외과수술
Superior mesenteric artery syndrome%Diagnosis%Surgical precedures,operative
目的 对肠系膜上动脉压迫综合征(superior mesenteric artery compressing syndrome，SMACS)的诊断及术式选择进行评价。方法 对河南省人民医院2000年1月至2010年12月期间收治的28例SMACS患者的临床资料进行回顾性分析。结果 本组病例均行X线钡餐检查，有23例呈典型的十二指肠水平段与升段交界处纵行受压迫征象（笔杆征）。手术治疗28例，其中包括Treitz韧带切断松解术4例，单纯胃空肠吻合术2例，Treitz韧带松解加十二指肠空肠Roux-en-Y吻合术11例，胃大部切除、胃空肠吻合术（BillrothⅡ式）7例及肠系膜上血管前十二指肠空肠吻合术4例。全部病例均治愈出院。结论 SMACS主要的确诊手段为X线钡餐造影。手术治疗效果以Treitz韧带松解加十二指肠空肠Roux-en-Y吻合术为最佳。
目的 對腸繫膜上動脈壓迫綜閤徵(superior mesenteric artery compressing syndrome，SMACS)的診斷及術式選擇進行評價。方法 對河南省人民醫院2000年1月至2010年12月期間收治的28例SMACS患者的臨床資料進行迴顧性分析。結果 本組病例均行X線鋇餐檢查，有23例呈典型的十二指腸水平段與升段交界處縱行受壓迫徵象（筆桿徵）。手術治療28例，其中包括Treitz韌帶切斷鬆解術4例，單純胃空腸吻閤術2例，Treitz韌帶鬆解加十二指腸空腸Roux-en-Y吻閤術11例，胃大部切除、胃空腸吻閤術（BillrothⅡ式）7例及腸繫膜上血管前十二指腸空腸吻閤術4例。全部病例均治愈齣院。結論 SMACS主要的確診手段為X線鋇餐造影。手術治療效果以Treitz韌帶鬆解加十二指腸空腸Roux-en-Y吻閤術為最佳。
목적 대장계막상동맥압박종합정(superior mesenteric artery compressing syndrome，SMACS)적진단급술식선택진행평개。방법 대하남성인민의원2000년1월지2010년12월기간수치적28례SMACS환자적림상자료진행회고성분석。결과 본조병례균행X선패찬검사，유23례정전형적십이지장수평단여승단교계처종행수압박정상（필간정）。수술치료28례，기중포괄Treitz인대절단송해술4례，단순위공장문합술2례，Treitz인대송해가십이지장공장Roux-en-Y문합술11례，위대부절제、위공장문합술（BillrothⅡ식）7례급장계막상혈관전십이지장공장문합술4례。전부병례균치유출원。결론 SMACS주요적학진수단위X선패찬조영。수술치료효과이Treitz인대송해가십이지장공장Roux-en-Y문합술위최가。
Objective To evaluate the diagnosis and operative modality for superior mesenteric artery compressing syndrome (SMACS). Methods The clinical data of 28 SMACS cases from January 2000 to December 2010 at this hospital was analyzed retrospectively.Results All patients underwent barium meal examination and the diagnosis was established according to clinical symptom and barium study. The 28 cases of SMACS underwent surgical treatment. The operative modalities included lysis and downward movement of the Treitz ligament and extensive mobilization of the duodenum in 4 cases, gastrojejunal anastomosis in 2 cases, lysis of the Treitz ligament and Roux-en-Y duodenojejunostomy in 11 cases, Billroth Ⅱ gastrectomy in 7 cases, and anterior duodenojejunostomy in 4 cases. All patients were cured and discharged from hospital.Conclusions The diagnosis of SMACS should mainly on barium meal examination besides the typical clinical manifestations such as epigastric distending pain and vomiting. Lysis of the Treitz ligament and Roux-en-Y duodenojejunostomy is appropriate surgical procedure to deal with SMACS.
