感染性腹主动脉瘤患者的诊断与外科治疗  

Diagnosis and surgical treatment of infectious abdominal aortic aneurysm

作　　者：孙岩[1] 张十一[1] 刘洋1 金星1 吴学君[1] 种振岳[1] 

机构地区：[1]山东大学附属省立医院血管外科,济南250021

出　　处：《中华医学杂志》2011年第43期3071-3073,共3页National Medical Journal of China

摘　　要：目的探讨感染性腹主动脉瘤的诊断与外科治疗。方法山东大学附属省立医院血管外科2010年收治3例感染性腹主动脉瘤患者，行腋-双股动脉旁路术＋感染性腹主动脉瘤切除术治疗。结果3例患者均一期手术成功，无手术死亡。手术时间平均5．5h，术中出血平均1500ml，无手术并发症，术后应用抗生素2周，手术切口一期愈合，均顺利出院。随访4个月，3例患者均无发热，无腹部症状，无间歇性跛行症状，复查超声提示人工血管通畅。结论腋-双股动脉旁路术＋感染性腹主动脉瘤切除术可有效切除感染的动脉瘤，保证下肢的动脉血供，同时避免移植物的感染。近期效果好，其远期疗效有待进一步随访。Objective To explore the diagnosis and surgical treatment of infectious abdominal aortic aneurysm （IAAA）. Methods All 3 IAAA patients at our department in 2010 underwent the combined procedures of axillary-bilateral femoral arterial bypass and IAAA resection. Their clinical data were collected and analyzed. Results There was no intraoperative death or complication. On average, the operative duration was 5 hours and the estimated blood loss 1500 ml. All patients received a 2-week post-operative regimen of antibiotics. And they recovered with healed incision in the first intention. No fever, abdominal symptom or intermittent claudication occurred during a 4-month follow-up period. Conclusion Axillary-bilateral femoral arterial bypass plus IAAA resection is an effective surgical procedure for resecting IAAA, assuring arterial blood supply to lower limbs and preventing post-operative graft infections. The short-term therapeutic efficacy is satisfactory, but its long-term efficacy requires further follow-ups.

关 键 词：主动脉瘤 腹 切除 移植物 腋-双股动脉旁路术 

分 类 号：R65[医药卫生—外科学]