摘要
目的探讨腹部卒中的病因、发病特点、诊断和治疗,引起临床医生的重视。方法回顾性分析1994～2006年期间国内232例腹部卒中的临床资料,并复习国外相关文献。结果腹部卒中国内以45～70岁为高发年龄段,国外以50～59岁为高发年龄段;男性少于女性,男女之比国外为1∶2.5,国内为1∶1.4;病因多样化,起病急骤,临床表现复杂,以腹痛和失血性休克为主要表现,伴消化道症状;术前确诊率低,国外为2.3%,我们的统计资料中确诊率为1.7%;无特异性检查手段,腹腔穿刺有较大临床价值,结合B超、CT、MRI和选择性腹腔动脉造影有利于提高确诊率;手术治疗总死亡率为7.3%,有7.8%的患者术中找不到明确的出血部位,其死亡率为41.2%。结论腹部卒中临床罕见,术前确诊率低,预后差,手术治疗为首选方法,手术关键是结扎破裂血管。
Objective To investigate the etiology, clinical characteristics, diagnosis and treatment of abdominal apoplexy, arousing clinic doctors＇ attention to this disease. Methods Two hundred and thirty-two domestic cases with abdominal apoplexy were analyzed retrospectively and related literatures in and abroad were reviewed. Resuits Abdominal apoplexy occured mainly patients aged 45 to 70 years in China and 50 to 59 years abroad. It was more common in women than in men, and male to female ratio was 1 to 1.4 in China and 1 to 2.5 abroad. There were various etiological factors to this disease. It was usually abrupt, with complicated clinical manifestation. The main symptoms were abdominal pain and hemorrhagic shock with nauseat, vomiting and diarrhea. Preoperative diagnosis rate of abdominal apoplexy was very low, literatures showed only 1.7% in China and 2.3% abroad. There was no particular evaluation approach. Abdominal cavity puncture, combined with CT, ultrasound, MRI and selective abdominal angiography helped to raise diagnosis rate. Overall postoperative mortality was 7.3%. In 7.8% cases, no bleeding site could be found during laparotomy, and the mortality rate was 41.2%. Conclusion Abdominal apoplexy is rarely seen in clinic with low preoperative diagnosis rate and poor prognosis. The first choice management is exploratory laparotomy, and the key is to ligate ruptured vessels.
出处
《中国普外基础与临床杂志》
CAS
2007年第5期619-622,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
腹部卒中
诊断
治疗
Abdominal apoplexy Diagnosis Treatment
