肾动脉水平以下腹主动脉瘤的诊断和治疗(附261例报告)  

Diagnosis and Treatment of Abdominal Aortic Aneurysms (A Report of 261 Cases)

作　　者：陈福真[1] 王玉琦[1] 符伟国[1] 杨珏[1] 叶建荣[1] 吴肇光[1] 

机构地区：[1]上海医科大学附属中山医院血管外科

出　　处：《中国普通外科杂志》1998年第5期257-259,266,共4页China Journal of General Surgery

摘　　要：为提高腹主动脉瘤手术的安全性，对１９６０年１月～１９９７年１２月２６１例肾动脉水平以下腹主动脉瘤的处理进行了分析。１９７０年以前手术切除７３例，其中５０例经主动脉造影确诊。１９８７年以来的１７８例由Ｂ超和ＣＴ确诊，５例行动脉造影或数字减影造影（ＤＳＡ）、５例经磁共振血管成像明确了动脉瘤上界和肾动脉的关系。结果：患者均行动脉瘤切除人造血管移植，手术死亡率３．８％，５年存活率７４．４１％。腹主动脉瘤诊断中最为关键的是确定动脉瘤上界与肾动脉间的距离，若Ｂ超与ＣＴ不能肯定，主动脉造影或ＤＳＡ极有帮助。提示：手术操作和麻醉技术的改进使腹主动脉瘤修补术变得更为迅速、安全和方便。In order to improve the surgery safety of infrarenal abdominal aortic aneurysm (AAA), we presented the experiences of diagnosis and treatment of 261 patients with AAA who had been admitted to our hospital from January 1960 to December 1997. Seventy three patients undertook the operation before 1970, 50 of whom the diagnosis were established by arteriography. Since 1987, the diagnosis has been established by the ultrasonography and CT in 178 patients, by arteriography and DSA in 5 and by magnetic resonane angiography (MRA) in 5. All of these patients underwent AAA resection and synthetic proshesis replacement. The operative mortality was 3.8% and the five year survival rate was 74.4%. The key point of diagnosis was to define the distance between renal artery and the neck of the aneurysm. If it could not be delineated by ultrasonography and CT, arteriography would provide much information to the delineation. The improvement of surgical and anesthetic techqniques made the AAA operation rapid and safe.

关 键 词：主动脉瘤 诊断 腹主动脉瘤 外科手术 肾动脉 

分 类 号：R543.16[医药卫生—心血管疾病] R730.56[医药卫生—内科学]