孤立性髂动脉瘤36例的临床诊断和治疗  

Clinical diagnosis and treatment of isolated iliac artery aneurysm

作　　者：钱水贤[1] 李克[1] 戴雪明[1] 茅届齐[1] 井上芳德[2] 菅野範英[2] 李向锋[2] 岩井武尚[2] 

机构地区：[1]上海交通大学附属上海第一人民医院血管外科,200080 [2]东京医科齿科大学附属病院血管外科

出　　处：《中华普通外科杂志》2007年第5期332-334,共3页Chinese Journal of General Surgery

摘　　要：目的提高对孤立性髂动脉瘤（isolated iliae artery aneurysm,IIAA）的认识,总结临床诊断和治疗经验。方法回顾性分析1983年1月至2006年3月期间收治的36例IIAA的临床资料。无症状患者17例,有症状患者19例。择期手术治疗33例,急诊手术3例。治疗措施主要包括动脉瘤切除和动脉重建术。辅助手术包括输尿管松解术和输尿管切断再缝合。结果择期手术术后发生切口延期愈合1例,臀肌跛行2例,下肢运动和排尿障碍1例,均经药物保守治疗,症状减轻和消失,其余患者均康复良好出院。急诊手术3例于术后死亡。结论IIAA临床罕见,破裂出血死亡率高,早期诊断和手术治疗是降低死亡率的关键。微创血管腔内治疗术是值得推荐应用的方法。Objective To improve the knowledge about isolated iliac artery aneurysm （IIAA） and sum up clinical experience for the diagnosis and treatment of IIAA. Methods The clinical data of 36 patients with IIAA were reviewed during a period of 23 years. Seventeen patients were free of symptom and 19 symptomatic. Elective operation was performed in thirty-three patients and emergency operation in three patients. The surgical procedure included radical standard aneurysmectomy with arterial reconstruction, and adjunctive operation of ureterolysis and ureteroureterostomy. Result Postoperative complications in elective group included delayed wound healing in one, hip claudication in two, lower limb movement and urination dysfunction in another one patient. All the symptoms improved and disappeared after symptomatic treatment. All three emergency patients died within 30 days postoperatively. Conclusions IIAA is rare clinically, with high mortality from aneurismal rupture bleeding, early diagnosis and surgical treatment is the key to reducing mortality. Minimally invasive endovascular surgery is worthy of recommending.

关 键 词：髂动脉瘤 血管外科手术 腔内治疗 

分 类 号：R686[医药卫生—骨科学]