内脏动脉瘤诊治经验  

Diagnosis and Treatment of Visceral Artery Aneurysms

作　　者：杨珏[1] 陈福真[1] 史振宇[1] 吴肇光[1] 符伟国[1] 

机构地区：[1]复旦大学医学院附属中山医院血管外科,上海200032

出　　处：《腹部外科》2001年第2期70-73,共4页Journal of Abdominal Surgery

摘　　要：目的　探讨内脏动脉瘤的诊断和治疗方法。方法　对 71例内脏动脉瘤的诊断和治疗进行回顾性总结。结果　 71例内脏动脉瘤中包括脾动脉瘤 2 2例 ,肝动脉瘤 16例 ,腹腔干动脉瘤 4例 ,胃、胰十二指肠动脉瘤 13例 ,肠系膜上、下动脉瘤分别为 6例和 1例 ,网膜动脉瘤 3例 ,肾动脉瘤 6例。本组自发性破裂大出血 2 9例 ,其中破裂入胆道 14例 ,上消化道 10例 ,腹腔及腹膜后 5例。术前经内脏动脉造影确诊 (包括DSA) 4 2例 ,螺旋CT血管造影 (SCTA)证实 14例 ,经核磁共振血管造影 (MRA)确诊 4例。手术治疗 5 8例 ,死亡 9例 ;动脉栓塞治疗 7例。结论　内脏动脉瘤术前临床诊断极为困难。DSA、SCTA和MRA具有诊断价值。一旦确诊 ,应尽早手术治疗。Objective To evaluate the diagnosis and treatment of visceral artery aneurysms.Methods The clinical data of 71 patients with visceral artery aneurysms at Zhongshan hospital during the past 40 years were reviewed retrospectively.Results Of the 71 cases of visceral artery aneurysms, 22 were diagnosed as having the splenic artery aneurysm, 16 having hepatic artery aneurysm, 4 having the celiac artery aneurysm, 13 having the gastroduodenal pancreatic artery aneurysm, 7 having the mesenteric artery aneurysm , 6 having renal artery aneurysm, and 3 having gastroepiploic artery aneurysm. Rupture occurred in 29 patients. The aneurysms ruptured into the bile tract in 14 patients, into the upper gastrointestinal tract in 10 and into the abdominal cavity or retroperitonum in 5. Correct preoperative diagnosis by selective visceral arteriography(including DSA) was made in 42 cases, by SCTA in 14 cases, by MRA in 4 cases. Forty eight patients were treated by surgery and 9 died, and 7 patients underwent selective embolization of the visceral artery aneurysms.Conclusions Preoperative diagnosis of visceral artery aneurysm is very difficult. The most valuable examination includes selective visceral arteriography, SCTA and MRA. Surgical approach is the recommended treatment in most patients.

关 键 词：内脏动脉瘤 动脉造影 动脉栓塞治疗 外科手术 少见病 

分 类 号：R543.16[医药卫生—心血管疾病]