十例腹主动脉损伤的诊疗体会  

Emergency management of abdominal aorta injury in 10 cases

作　　者：张赞松[1] 段志泉[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属一院血管外科,沈阳110001

出　　处：《中华普通外科杂志》2007年第5期341-343,共3页Chinese Journal of General Surgery

摘　　要：目的探讨腹主动脉损伤发生的原因及诊疗方法。方法回顾性分析1995-2004年间收治的10例腹主动脉损伤的临床资料。本组10例,男6例,女4例。病因主要包括医源性损伤5例、刀刺伤3例、火器伤1例、交通肇事1例。仅3例术前行腹主动脉造影、增强CT等影像学检查;7例经综合临床判断直接手术治疗。结果10例患者分别采取单纯修补、人工血管移植等术式。存活8例,死亡2例,均死于延误诊断,休克过重而持久。1例因合并髂静脉损伤,虽经血管重建,术后遗留轻度患肢水肿。结论快速诊断、迅速建立有效静脉通路输血补液,紧急剖腹止血是抢救成功的关键。术中应注意全面探查,视伤情尽量采用简单而合理的术式。Objective To probe the etiology, diagnosis and treatment of abdominal aorta injury. Methods A retrospective analysis was made on 10 cases admitted from 1995 to 2004 of abdominal aorta injury. Results There were 6 males and 4 females. The injuries were of iatrogenic trauma （ n = 5 ）, stabbing （ n = 3 ）, gunshot （ n = 1 ） and traffic accident （ n = 1 ）. Three cases underwent imaging examnation such as aorta angiography and CT enhancement scanning, while seven cases underwent emergency operation based on the clinical judgement. The main operative methods included primary repair of abdominal aorta and synthetic prosthesis interposition. Two cases died preoperatively. Postoperatively, all 8 cases were cured with one complication in which slight left lower extremity swelling as a result of repair for concomitant iliac vein injury. Conclusions More attention should be paid to the increasing tendency of abdominal aorta iatrogenic injury. Rapid diagnosis, efficient resuscitation and haemostasis are the key of successful therapy. Comprehensive exploration, simple and effective repair could save patients life.

关 键 词：创伤和损伤 主动脉 腹 诊断 治疗 

分 类 号：R686[医药卫生—骨科学]