• 1. 新疆維吾爾自治區(qū)人民醫(yī)院血管外科(新疆烏魯木齊 830000);;
  • 2. 新鄉(xiāng)醫(yī)學(xué)院第三附屬醫(yī)院普外科(河南新鄉(xiāng) 453003);

目的  探討破裂腹主動脈瘤的診斷和外科治療方法。
方法  回顧性分析2000年1月至2010年12月期間新疆維吾爾自治區(qū)人民醫(yī)院收治的20例破裂腹主動脈瘤患者的臨床資料。
結(jié)果  男18例,女2例;年齡31~82歲,平均65.4歲。所有患者中突發(fā)性腹或腰背部疼痛20例,血壓下降和(或)休克11例,發(fā)病前有明確腹主動脈瘤病史7例。所有患者均經(jīng)彩超、CTA或手術(shù)探查確診。19例患者采用傳統(tǒng)開腹手術(shù),1例行腔內(nèi)支架人工血管置入術(shù)。20例患者中圍手術(shù)期死亡4例,死亡率為20%,死亡原因?yàn)檠h(huán)衰竭1例,多器官功能障礙綜合征3例。存活的16例患者恢復(fù)順利。
結(jié)論  手術(shù)治療破裂腹主動脈瘤有效,早期診斷,急診外科手術(shù),是降低病死率的關(guān)鍵。

引用本文: 賽力木,姜孝奎,戈小虎. 破裂腹主動脈瘤的外科治療體會(附20 例報道). 中國普外基礎(chǔ)與臨床雜志, 2012, 19(5): 534-537. doi: 復(fù)制

1. 趙紀(jì)春, 汪靜, 金立人, 等. 腹主動脈瘤60 例的診治經(jīng)驗(yàn) [J]. 中華普通外科雜志, 2003, 18(9):571.
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):714-730.
3. Eliason JL, Upchurch GR Jr. Endovascular abdominal aortic aneurysm repair [J]. Circulation, 2008, 117(13):1738-1744.
4. 孫海軍, 劉冰, 薛冬波, 等. 腹主動脈瘤破裂的臨床分析( 附6 例報告) [J]. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(2):213-214.
5. 劉仁貴, 趙紀(jì)春, 黃斌. 破裂腹主動脈瘤的外科治療及預(yù)后 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(3):316-319.
6. Noel AA, Gloviczki P, Cherry KJ Jr, et al. Ruptured abdominal aortic aneurysms:the excessive mortality rate of conventional repair [J]. J Vasc Surg, 2001, 34(1):41-46.
7. 葉財(cái)盛, 李松奇, 李曉曦, 等. 腹主動脈瘤破裂的處理及預(yù)后分析 [J]. 中華普通外科雜志, 2007, 22(5):338-340.
8. Frego M, Bianchera G, Angriman I, et al. Ruptured aneurysms of the abdominal aorta:from the First Aid to the Operating Room.Changing concepts [J]. Ann Ital Chir, 2007, 78(4):277-281.
9. 宋揚(yáng), 沈洪, 劉全達(dá). 國內(nèi)原發(fā)性主動脈消化道瘺14 例臨床分析 [J]. 中國急救醫(yī)學(xué), 2005, 25(4):299-301.
10. Saers SJ, Scheltinga MR. Primary aortoenteric fistula [J]. Br J Surg, 2005, 92(2):143-152.
11. Lawlor DK, Derose G, Harris KA, et al. Primary aorto/iliac-enteric fistula-report of 6 new cases [J]. Vasc Endovascular Surg,2004, 38(3):281-286.
12. 李雪松, 賽里木, 戈小虎. 原發(fā)性主動脈消化道瘺的診斷和治療(1 例報道并文獻(xiàn)復(fù)習(xí)) [J]. 中國普外基礎(chǔ)與臨床雜志,2009, 16(12):1033-1034.
13. Büket S, Atay Y, Islamo?lu F, et al. Proximal clamping levels in abdominal aortic aneurysm surgery [J]. Tex Heart Inst J, 1999,26(4):264-268.
14. 舒暢, 宮毅, 李全明, 等. 球囊導(dǎo)尿管在腹主動脈瘤破裂手術(shù)救治中的應(yīng)用 [J]. 中華普通外科雜志, 2007, 22(5):391-392.
15. Yusuf SW, Whitaker SC, Chuter TA, et al. Emergency endovascular repair of leaking aortic aneurysm [J]. Lancet, 1994,344(8937):1645.
16. O’Donnell ME, Badger SA, Makar RR, et al. Techniques in occluding the aorta during endovascular repair of ruptured abdominal aortic aneurysms [J]. J Vasc Surg, 2006, 44(1):211-215.
17. Ohki T, Veith FJ. Endovascular grafts and other image-guided catheter-based adjuncts to improve the treatment of ruptured aortoiliac aneurysms [J]. Ann Surg, 2000, 232(4):466-479.
18. Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms:systematic literature review [J]. Vascular, 2008, 16(4):219-224.
19. Visser JJ, Bosch JL, Hunink MG, et al. Endovascular repair versus open surgery in patients with ruptured abdominal aortic aneurysms:clinical outcomes with 1-year follow-up [J]. J Vasc Surg,2006, 44(6):1148-1155.
  1. 1. 趙紀(jì)春, 汪靜, 金立人, 等. 腹主動脈瘤60 例的診治經(jīng)驗(yàn) [J]. 中華普通外科雜志, 2003, 18(9):571.
  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):714-730.
  3. 3. Eliason JL, Upchurch GR Jr. Endovascular abdominal aortic aneurysm repair [J]. Circulation, 2008, 117(13):1738-1744.
  4. 4. 孫海軍, 劉冰, 薛冬波, 等. 腹主動脈瘤破裂的臨床分析( 附6 例報告) [J]. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(2):213-214.
  5. 5. 劉仁貴, 趙紀(jì)春, 黃斌. 破裂腹主動脈瘤的外科治療及預(yù)后 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(3):316-319.
  6. 6. Noel AA, Gloviczki P, Cherry KJ Jr, et al. Ruptured abdominal aortic aneurysms:the excessive mortality rate of conventional repair [J]. J Vasc Surg, 2001, 34(1):41-46.
  7. 7. 葉財(cái)盛, 李松奇, 李曉曦, 等. 腹主動脈瘤破裂的處理及預(yù)后分析 [J]. 中華普通外科雜志, 2007, 22(5):338-340.
  8. 8. Frego M, Bianchera G, Angriman I, et al. Ruptured aneurysms of the abdominal aorta:from the First Aid to the Operating Room.Changing concepts [J]. Ann Ital Chir, 2007, 78(4):277-281.
  9. 9. 宋揚(yáng), 沈洪, 劉全達(dá). 國內(nèi)原發(fā)性主動脈消化道瘺14 例臨床分析 [J]. 中國急救醫(yī)學(xué), 2005, 25(4):299-301.
  10. 10. Saers SJ, Scheltinga MR. Primary aortoenteric fistula [J]. Br J Surg, 2005, 92(2):143-152.
  11. 11. Lawlor DK, Derose G, Harris KA, et al. Primary aorto/iliac-enteric fistula-report of 6 new cases [J]. Vasc Endovascular Surg,2004, 38(3):281-286.
  12. 12. 李雪松, 賽里木, 戈小虎. 原發(fā)性主動脈消化道瘺的診斷和治療(1 例報道并文獻(xiàn)復(fù)習(xí)) [J]. 中國普外基礎(chǔ)與臨床雜志,2009, 16(12):1033-1034.
  13. 13. Büket S, Atay Y, Islamo?lu F, et al. Proximal clamping levels in abdominal aortic aneurysm surgery [J]. Tex Heart Inst J, 1999,26(4):264-268.
  14. 14. 舒暢, 宮毅, 李全明, 等. 球囊導(dǎo)尿管在腹主動脈瘤破裂手術(shù)救治中的應(yīng)用 [J]. 中華普通外科雜志, 2007, 22(5):391-392.
  15. 15. Yusuf SW, Whitaker SC, Chuter TA, et al. Emergency endovascular repair of leaking aortic aneurysm [J]. Lancet, 1994,344(8937):1645.
  16. 16. O’Donnell ME, Badger SA, Makar RR, et al. Techniques in occluding the aorta during endovascular repair of ruptured abdominal aortic aneurysms [J]. J Vasc Surg, 2006, 44(1):211-215.
  17. 17. Ohki T, Veith FJ. Endovascular grafts and other image-guided catheter-based adjuncts to improve the treatment of ruptured aortoiliac aneurysms [J]. Ann Surg, 2000, 232(4):466-479.
  18. 18. Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms:systematic literature review [J]. Vascular, 2008, 16(4):219-224.
  19. 19. Visser JJ, Bosch JL, Hunink MG, et al. Endovascular repair versus open surgery in patients with ruptured abdominal aortic aneurysms:clinical outcomes with 1-year follow-up [J]. J Vasc Surg,2006, 44(6):1148-1155.