急性Stanford A型主动脉夹层（ATAAD）是一种严重的疾病，起病后常累及主动脉分支动脉，导致脏器灌注不良。当并发肠系膜灌注不良综合征（mesMPS）时，因临床表现不典型，并且缺乏特异的实验室检查和影像学表现，容易延迟诊断，住院期间死亡率高。目前，国内外很多学者对于ATAAD的治疗策略尚无一致性的意见，传统的急诊开放主动脉修复术的术后并发症发生率较高，预后差。因此，优先进行主动脉修复，还是恢复肠系膜上动脉血流灌注仍然存在争议。笔者就ATAAD合并mesMPS相关的发病机制、诊断和治疗策略研究进展进行综述，旨在为临床医生提供早期诊断和精准治疗的依据。

Acute Stanford type A aortic dissection （ATAAD） frequently involves the branch arteries after onset， leading to impaired organ perfusion. When complicated with mesenteric malperfusion syndrome（mesMPS）， the diagnosis is likely to be delayed due to non-specific clinical manifestations and the lack of specific laboratory tests and imaging findings. In-hospital mortality remains high for this condition. There is no consensus among scholars at home and abroad on the treatment strategy of this acute and critical disease，and emergent open aortic repair is a traditional treatment measure. However， this approach is associated with high rates of postoperative complications and poor long-term prognosis. Therefore， there is controversy over whether aortic repair or restore superior mesenteric artery perfusion restoration should be prioritized. This article reviews the current research on the pathogenesis， diagnosis and treatment strategies for ATAAD complicated with mesMPS， aiming to provide a basis for clinicians to diagnose and accurately treat this disease.