CAJ | 학술논문

目的探讨孤立性腹腔干及肠系膜上动脉(SMA)夹层的诊断及治疗方法.方法收集中山大学附属第三医院收治的2例孤立性腹腔干并SMA夹层的临床资料,并结合文献报道的119例病例,对孤立性内脏动脉夹层(IDVA)的诊断及治疗方法进行分析总结.结果 119例IDVA中69例存在相关症状,全部病例均由增强CT或MRI检查确诊.发现IDVA后,采取外科治疗8例,支架置入术5例,保守治疗106例,均取得满意疗效.本组2例患者亦由CT检查发现,并经血管造影证实,1例行降压、抗凝治疗,1例行支架置入术,随访中均无不适.结论腹腔增强CT或MRI检查是诊断IDVA的主要方法.大部分IDVA可选择保守治疗,但需密切CT随访病变情况;对于动脉破裂、管腔阻塞及保守治疗中夹层进展者,需行腔内介入治疗或外科手术治疗.
목적 탐토고립성복강간급장계막상동맥(SMA)협층적진단급치료방법.방법 수집중산대학부속제삼의원수치적2례고립성복강간병SMA협층적림상자료,병결합문헌보도적119례병례,대고립성내장동맥협층(IDVA)적진단급치료방법진행분석총결.결과 119례IDVA중69례존재상관증상,전부병례균유증강CT혹MRI검사학진.발현IDVA후,채취외과치료8례,지가치입술5례,보수치료106례,균취득만의료효.본조2례환자역유CT검사발현,병경혈관조영증실,1례행강압、항응치료,1례행지가치입술,수방중균무불괄.결론 복강증강CT혹MRI검사시진단IDVA적주요방법.대부분IDVA가선택보수치료,단수밀절CT수방병변정황;대우동맥파렬、관강조새급보수치료중협층진전자,수행강내개입치료혹외과수술치료.
Objective To investigate the diagnosis and treatment of isolated celiac artery (CA) dissection and superior mesenteric artery (SMA) dissection.MethodsIntegrating clinical data of 119 cases with isolated dissection of the visceral arteries ( IDVA ) reported in literature and 2 patients with spontaneous isolated dissections of both CA and SMA treated in the Third Affiliated Hospital of Sun Yat-sen University,the diagnosis and treatment of IDVA were analyzed retrospectively.Results Among 119 cases reported in the literature,69 cases were symptomatic.All of the cases were diagnosed by contrast-enhanced abdominal CT or MRI.After IDVA was discovered,surgical treatment and endovascular stent placement was performed in 8 and 5 patients respectively,although the remaining 106 patients were managed conservatively with good results.In our 2 cases,the diagnosis of CA and SMA dissection was established by contrastenhanced CT and confirmed by conventional angiograghy.One patient was treated with anticoagulation and antihypertension,and the other patient was treated with endovascular stenting.Both of the patients didn't have discomfort during the follow-up period of 12 and 3 months respectively.ConclusionsContrastenhanced abdominal CT is the main tool for detection of IDVA.Most of the patients with IDVA can be managed conservatively,but close surveillance with imaging studies is necessary for early recognition of dissection progression.Patients with persistent or relapsed symptoms,and dissection progression,should undergo surgical or endovascular treatment.