CAJ | 학술논문

目的：探讨自发孤立性肠系膜上动脉夹层（SISMAD）临床特点及介入治疗。方法回顾性分析2006年1月至2014年6月北京大学人民医院收治并行介入治疗的10例SISMAD患者的临床资料。10例均为男性,年龄44~66岁,平均（53±8）岁,均表现为急性上腹痛或脐周痛,经保守治疗效果欠佳后行自膨式裸支架植入治疗。结果10例患者均成功植入支架（7例植入1枚,3例植入2枚）,术中肠系膜上动脉真腔血流恢复,残余狭窄率小于15%,技术成功率为100%；8例腹痛在术后当天缓解,2例在术后2 d缓解。术后随访7~71个月（平均36个月）,随访率100%,患者未再出现腹部不适症状；术后6、12、24个月腹部增强CT显示肠系膜上动脉和支架内血流通畅,未见明显瘤样扩张。结论自膨式裸支架植入治疗SISMAD是安全可行的,中长期效果满意。
목적：탐토자발고립성장계막상동맥협층（SISMAD）림상특점급개입치료。방법회고성분석2006년1월지2014년6월북경대학인민의원수치병행개입치료적10례SISMAD환자적림상자료。10례균위남성,년령44~66세,평균（53±8）세,균표현위급성상복통혹제주통,경보수치료효과흠가후행자팽식라지가식입치료。결과10례환자균성공식입지가（7례식입1매,3례식입2매）,술중장계막상동맥진강혈류회복,잔여협착솔소우15%,기술성공솔위100%；8례복통재술후당천완해,2례재술후2 d완해。술후수방7~71개월（평균36개월）,수방솔100%,환자미재출현복부불괄증상；술후6、12、24개월복부증강CT현시장계막상동맥화지가내혈류통창,미견명현류양확장。결론자팽식라지가식입치료SISMAD시안전가행적,중장기효과만의。
Objective To investigate the clinical features of spontaneous isolated superior mesenteric artery dissection (SISMAD), and to discuss its interventional therapy. Methods The clinical data of 10 patients with SISMAD, who were admitted to authors' hospital to receive interventional treatment during the period from January 2006 to June 2014, were retrospectively analyzed. All the 10 patients were males, aged 44-66 years with a mean of (53±8) years. Clinically, all patients presented with acute-onset abdominal pain or pain around umbilicus, as the effect of conservative treatment was poor, implantation of self-expandable bare stent was carried out. Results Successful implantation of self-expandable bare stent was accomplished in all 10 patients;only one stent was used in 7 patients and 2 stents were used in 3 patients. The blood in the true lumen of superior mesenteric artery (SMA) restored and the residual stenosis extent was less than 15%. The technical success rate was 100%. The abdominal pain was relieved in 8 patients on the operative day after treatment, and in 2 patients the abdominal pain was relieved in 2 days after treatment. All the patients were followed up for 7-71 months (mean of 36 months) and the follow-up rate was 100%. After the treatment patients had no symptoms of abdominal discomfort. Contrast-enhanced CT scan performed at 6, 12 and 24 months after the treatment showed that SMA and stent was patent and no aneurysmal dilatation was observed. Conclusion For the treatment of SISMAD endovascular implantation of self-expandable bare stent is clinically safe and feasible, and its long-term effect is satisfactory.