股动脉瘤诊断和外科治疗(附81例报告)  

Diagnosis and surgical treatment of femoral arterial aneurysms: a report of 81 cases

作　　者：胡海地[1] 冯勇[2] 常青[1] 刘翀[1] 陈喆[1] 段志泉[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属第一医院普通外科研究所血管甲状腺外科,辽宁沈阳110001 [2]中国医科大学附属盛京医院外科,辽宁沈阳110004

出　　处：《中国实用外科杂志》2009年第12期1030-1032,共3页Chinese Journal of Practical Surgery

基　　金：辽宁省自然科学基金资助(20042065)

摘　　要：目的总结股动脉瘤(FAA)的诊治经验。方法回顾性分析1984年1月至2009年8月中国医科大学附属第一医院收治的81例FAA病人的临床资料。结果男62例,女19例,年龄16～75岁,平均(57±13)岁。81例有82个FAA,其中76个股总动脉瘤、4个股浅动脉瘤和2个股深动脉瘤。病因:创伤47例(58.0%)、动脉粥样硬化28例(34.6%)、感染3例(3.7%)、大动脉炎1例(1.2%)、白塞病1例(1.2%)、原因不明1例(1.2%)。6例(7.4%)为多发性动脉瘤,5例(6.2%)为破裂性FAA。均行动脉瘤切除和下肢血运重建,术后早期3例发生急性下肢动脉闭塞,1例因肢体缺血、坏死截肢,2例取栓后血运恢复。术后67例得到随访,随访时间2个月至16年(平均5年3个月)。术后1年,1例大动脉炎病人因吻合口动脉瘤破裂、大出血死亡;6例于术后5年以上死于心脏疾病、肿瘤等;2例合并动脉硬化闭塞症有下肢慢性缺血症状。其余病人恢复良好,重建血管通畅,5年通畅率为85.9%。结论早期诊断、早期动脉瘤切除及血运重建,FAA可获得良好疗效。术后应长期随访,观察有否新生的动脉瘤。Objective To summarize the experience in the management of femoral arterial aneurysm （FAA）. Methods The clinical data of 81 patients with FAAs between JanuaD, 1984 and August 2009 in the First Affiliated Hospital of China Medical University were retrospectively reviewed. Results There were 62 （76.5%） male and 19 （23.5%） female patients, aging from 16 to 75 years （mean 57± 13 years）. There were 82 FAAs, including 76 （92.7%） common femoral aneurysms, 4 （4.9%） superficial femoral anem.wsms and 2 （2.4%） deep femoral anemTsms. The aneurysms were caused by trauma in 47 cases （58.0%）, ather,）sclerosis in 28 cases （34.6%）, infection in three （3.7%）, Takayasu disease in one （1.2%）, Beheet disease in one （1.2%） and unknown cause in one （1.2%）. Six patients （7.4%） had multiple aneurysms, 5 patients （6.2%） had ruptured FAAs. All patients were managed successfully with aneurysmectumy and restoration of the extremity circulation. During the perioperative period, 3 patients occurred acute ischemia of the lower limbs, one received amputation and two recovered after therombectonly. Sixty-seven patients were followed from 2 months to 16 years （mean 5 years and 3 months）, one patient with Takayasu disease died one year after operation, due to massive hemorrhage from a ruptured anastomotic aneuusm; 6 patients died more than 5 years after operation, due to cardiac diseases or carcinomas; 2 patients with atherosclerotic obliteran had chronic ischemia of the legs. The other surviving patients recovered well with no new vascular events and the reconstructed arteries were patent, with the long-term patency rate of 85.9% at 5 years. Conclusion Timely diagnosis, early surgical treatment by an aneurysmectomy with arterial reconstruction, can guarantee a good prognosis for FAAs. Lung-term follow-up is needed to survey a new aneurysm formation.

关 键 词：动脉瘤 股动脉 

分 类 号：R6[医药卫生—外科学]