目的:探讨急性自发性孤立性肠系膜上动脉夹层(ASISMAD)的发病特点及诊治策略的选择。方法:回顾性分析我院介入血管外科诊治的11例ASISMAD患者资料,分析其临床特点、诊治方案。结果:根据SISMAD的Yun分型,其中Ⅰ型3例、Ⅱa型3例、Ⅱb型2例、Ⅲ型3例。第1破口距肠系膜上动脉起始部平均距离为33mm,夹层的平均长度为57.72mm。7例保守治疗3~9d后腹痛症状逐渐缓解、消失。1例行弹簧圈栓塞术,1例行腔内裸支架置入术,1例行置管溶栓+罂粟碱灌注术,1例行肠系膜上动脉取栓+小肠切除术,腹痛症状均消失,但1例术后出现短肠综合征。结论:ASISMAD临床症状无特异性。保守治疗对绝大多数ASISMAD有效,若腹痛症状未缓解或加重,应改行腔内治疗或外科手术治疗。 Objective: To investigate the incidence of acute spontaneous solitary superior mesenteric artery dissection (ASISMAD) and the diagnosis and treatment options. Methods: Retrospective analysis of 11 cases of ASISMAD in our hospital involved in vascular surgery diagnosis and treatment of data, analysis of its clinical features, diagnosis and treatment programs. Results: According to Yun’s classification of SISMAD, there were 3 cases of type Ⅰ, 3 cases of type Ⅱa, 2 cases of type Ⅱb and 3 cases of type Ⅲ. The first break from the beginning of the superior mesenteric artery the average distance of 33mm, the average length of the interlayer 57.72mm. 7 cases of conservative treatment of 3 ~ 9d abdominal pain symptoms gradually eased, disappeared. One case underwent coil embolization, one case underwent endovascular stent placement, one received catheterization and papaverine infusion, one received superior mesenteric artery embolization + small intestine resection, the symptoms of abdominal pain disappeared, However, 1 case had short bowel syndrome after operation. Conclusion: The clinical symptoms of ASISMAD are not specific. Conservative treatment for the vast majority of ASISMAD effective, if not alleviate or aggravate abdominal symptoms should be diverted to endovascular treatment or surgical treatment.