Статья
Острая неокклюзионная мезентериальная ишемия
В обзоре представлен анализ современной научной литературы, посвященной острой неокклюзионной мезентериальной ишемии (ОНМИ) — тяжелейшей патологии с летальностью до 80 %. Рассматриваются ключевые аспекты патогенеза, основные факторы риска и особенности клинической картины, затрудняющие раннюю диагностику. Особое внимание уделено возможностям и ограничениям современных методов диагностики, включая мультиспиральную компьютерно-томографическую ангиографию (МСКТ-А) и определение биомаркеров. Подробно проанализированы стратегии консервативного лечения (антикоагулянтная, системная вазодилатационная терапия) и хирургических вмешательств, включая реваскуляризацию, резекцию нежизнеспособных участков кишки и тактику damage control surgery. Обсуждается критически важная роль эксплоративной лапаротомии и лапароскопии в верификации диагноза и интраоперационной оценки жизнеспособности кишечника. Подчеркивается необходимость мультидисциплинарного подхода и создания специализированных центров для улучшения исходов лечения.
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