Abstract:
ObjectiveTo investigate early detection methods for acute mesenteric ischemia (AMI), measures to improve efficacy, and risk factors affecting prognosis.
MethodsA total of 139 patients with acute occlusive mesenteric ischemia were selected as the study subjects, and divided into cure group (n=104) and death group (n=35) based on prognosis.Their clinical data such as onset characteristics, diagnostic methods, treatment effects, and prognosis were retrospectively analyzed.
ResultsAmong the 139 patients in this study, 40 cases were diagnosed with mesenteric artery embolism, 75 cases with mesenteric vein thrombosis, and 24 cases with mesenteric artery thrombosis.Among them, 18 cases underwent CTA/CTV examination, and 15 cases were directly diagnosed with AMI, with a sensitivity rate of 83.33%; 2 cases underwent digital subtraction angiography (DSA) examination, both were diagnosed with AMI.One hundred and three patients underwent surgical treatment, of which 26 cases died postoperatively, with a postoperative mortality rate of 25.24%; 34 patients underwent conservative treatment, of which 9 cases died, and the mortality rate after conservative treatment was 26.47%;2 patients undergoing intervention treatment were cured; the overall mortality rate of 139 patients was 25.18% (35/139).The influencing factors of prognosis were analyzed, and the results showed that increased age (OR=1.089, 95%CI: 1.004-1.182), elevated C-reactive protein levels (OR=1.015, 95%CI: 1.004-1.026), and elevated lactate levels(OR=4.302, 95%CI: 2.276-8.132) were all independent risk factors for death in AMI patients.
ConclusionsCTA/CTV and DSA examinations are helpful for the early diagnosis of AMI.Targeted treatment including surgery, conservative treatment, and intervention therapy, as well as comprehensive treatment are very important.Early intervention therapy can improve survival rates for eligible patients.Increased age and elevated levels of C-reactive protein and lactate are important factors in predicting poor prognosis of AMI.