• 四川大學華西醫(yī)院血管外科(成都610041);

目的總結(jié)分析腹主動脈瘤的診斷和外科治療經(jīng)驗。方法回顧性分析自1995年1月至2004年2月我科收治的72例腹主動脈瘤患者的臨床資料。術(shù)前根據(jù)患者癥狀和體征,分別采用彩色多普勒超聲、CT、MRA和DSA檢查明確診斷和擬定手術(shù)方案。其中腎動脈下型腹主動脈瘤行擇期腹主動脈瘤切除、人造血管移植術(shù)58例; 腎動脈上型假性腹主動脈瘤行擇期囊內(nèi)修復術(shù)1例; 腎動脈上型腹主動脈瘤行擇期腹主動脈瘤切除人造血管移植術(shù)1例; 腹主動脈瘤破裂行急診腹主動脈瘤切除、人造血管移植術(shù)12例。 結(jié)果彩色多普勒超聲、CT、MRA和DSA檢查均能確診腹主動脈瘤; 58例腎動脈下型腹主動脈瘤切除、人造血管移植擇期手術(shù),術(shù)后死于多器官功能衰竭2例,死亡率為3.45%,其余病例和2例腎動脈上型腹主動脈瘤均獲臨床治愈。12例腹主動脈瘤破裂者臨床治愈7例,5例術(shù)后死于多器官功能衰竭,死亡率為41.67%。結(jié)論加強腹主動脈瘤手術(shù)患者圍手術(shù)期評估和管理,尤其是保證術(shù)中內(nèi)環(huán)境穩(wěn)定,減少術(shù)中失血,可使腹主動脈瘤手術(shù)更為安全、有效。

引用本文: 趙紀春,馬玉奎,汪靜,金立人. 腹主動脈瘤72例診斷和外科治療分析. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(4): 307-310. doi: 復制

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2. Bown MJ, Sutton AJ, Bell PR, et al. A metaanalysis of 50 years of ruptured abdominal aortic aneurysm repair [J]. Br J Surg, 2002; 89(6)∶714.
3. Huber TS, Wang JG, Derrow AE, et al. Experience in the United States with intact abdominal aortic aneurysm repair [J]. J Vasc Surg, 2001; 33(2)∶304.
4. Nicholls SC, Gardner JB, Meissner MH, et al. Rupture in small abdominal aortic aneurysms [J]. J Vasc Surg, 1998; 28(5)∶884.
5. HassenKhodja R, Sala F, Bouillanne PJ, et al. Impact of aortic diameter on the outcome of surgical treatment of abdominal aortic aneurysm [J]. Ann Vasc Surg, 2001; 15(2)∶136.
6. No authors listed. Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. The UK Small Aneurysm Trial Participants [J]. Lancet, 1998; 352(9141)∶1649.
  1. 1. Hertzer NR, Mascha EJ, Karafa MT, et al. Open infrarenal abdominal aortic aneurysm repair: the Cleveland Clinic experience from 1989 to 1998 [J]. J Vasc Surg, 2002; 35(6)∶ 1145.
  2. 2. Bown MJ, Sutton AJ, Bell PR, et al. A metaanalysis of 50 years of ruptured abdominal aortic aneurysm repair [J]. Br J Surg, 2002; 89(6)∶714.
  3. 3. Huber TS, Wang JG, Derrow AE, et al. Experience in the United States with intact abdominal aortic aneurysm repair [J]. J Vasc Surg, 2001; 33(2)∶304.
  4. 4. Nicholls SC, Gardner JB, Meissner MH, et al. Rupture in small abdominal aortic aneurysms [J]. J Vasc Surg, 1998; 28(5)∶884.
  5. 5. HassenKhodja R, Sala F, Bouillanne PJ, et al. Impact of aortic diameter on the outcome of surgical treatment of abdominal aortic aneurysm [J]. Ann Vasc Surg, 2001; 15(2)∶136.
  6. 6. No authors listed. Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. The UK Small Aneurysm Trial Participants [J]. Lancet, 1998; 352(9141)∶1649.