肾下腹主动脉瘤的外科治疗  

Surgical treatment of infra-renal abdominal aortic aneurysm

作　　者：段红永[1,2] 管强[1,2] 杨笑非[1,2] 韩锋 梁宁[1,2] 刘增庆 

机构地区：[1]山西省人民医院 [2]山西医科大学附属人民医院血管外科,太原030012

出　　处：《中国血管外科杂志（电子版）》2012年第3期155-157,共3页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的总结肾下腹主动脉瘤(AAA)的手术治疗经验。方法回顾性分析1999年7月至2011年10月行开腹手术治疗的91例肾下AAA患者的临床资料。84例接受择期手术,7例行急诊手术。结果 1例AAA破裂急诊手术患者因失血性休克、弥散性血管内凝血于术中死亡,1例破裂急诊手术患者术后1周因多脏器功能衰竭死亡,1例择期手术患者术后第3日因急性大面积心肌梗死而死亡。82例患者获得随访,平均随访时间5.1年,术后3年死于心肌梗死及脑梗死各1例;其余患者常规性腹部及血管彩超检查,其中远端吻合口闭塞2例,肠梗阻2例,未发现吻合口假性动脉瘤等其它并发症。结论开腹手术治疗AAA效果确切,因手术技巧、麻醉及术后监护水平等的提高,死亡率较低。Objective To summarize the experiences of the surgical treatment of infra-renal abdominal aortic aneurysm (AAA). Methods From July 1999 to October 2011, the clinical data of 91 cases with infra-renal AAA who underwent surgical treatment were analyzed retrospectively. Among them, elective operation was performed on 84 cases, while emergency operation on 7 cases. Results There were 3 deaths during perioperation. Of these 3 cases, 1 with ruptured AAA died of hemorrhagic shock and disseminated intravascular coagulation during the emergency operation; 1 with ruptured AAA died of multiple organ failure one week after operation;1 died of acute myocardial infarction on 3-day after elective operation. Eighty-two cases were followed up for a mean period of 5.1 years. During the follow-up, 1 case died of myocardial infarction and 1 case died of cerebral infarction at 3-year postoperatively. Distal anastomotic block and intestinal obstruction were found in 2 cases by color Doppler ultrasonography, retrospectively. No other complications such as anastomotic pseudoaneurysm were found in all cases. Conclusion Surgical treatment of infra-renal AAA was effective. Its mortality can be decresed by the improvements of surgical expertise, anesthesia and perioperative intensive care.

关 键 词：肾下腹主动脉瘤 外科治疗 

分 类 号：R699.2[医药卫生—泌尿科学]