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急性肠系膜上动脉闭塞(superior mesenteric artery occlusion,SMAO)是临床上一种严重急腹症,起病急骤,病程进展迅速,病死率高。高病死率的主要原因是其临床症状、实验室和影像学检查均缺乏特异性,导致易漏诊误诊,进而延误治疗。近年来,随着CT血管成像(CT angiography,CTA)技术在临床上的应用,SMAO的早期诊断成为了可能。外科手术是主要的治疗手段,但创伤大、风险高、术后并发症多,因此在肠坏死发生前及时行介入治疗成为了一项必要选择。损伤控制外科理念的实施,可以减少术后并发症,特别是吻合口瘘的发生。总之,早诊断,早治疗是改善预后的关键。
Acute superior mesenteric artery occlusion (SMAO) is a clinically severe acute abdomen, with a sharp onset, rapid progression and high mortality. High mortality is mainly due to its clinical symptoms, laboratory and imaging studies are lack of specificity, leading to misdiagnosis misdiagnosis, and thus delay treatment. In recent years, with CT angiography (CT angiography, CTA) technology in clinical applications, early diagnosis of SMAO has become possible. Surgery is the main treatment, but trauma, high risk, postoperative complications, timely intervention in the preoperative occurrence of intestinal necrosis has become an essential choice. The implementation of the concept of injury control surgery can reduce postoperative complications, especially anastomotic leakage. In short, early diagnosis and early treatment is the key to improving prognosis.