内脏动脉瘤41例治疗分析  

Treatment of visceral artery aneurysms:an analysis of 41 cases

作　　者：孙小杰[1] 胡何节[1] 王晓天[1] 方征东[1] 葛新宝[1] 程灿[1] 邓汝淇 

机构地区：[1]安徽医科大学附属省立医院安徽省立医院血管外科,合肥230001 [2]亳州市人民医院血管外科,安徽亳州236800

出　　处：《中国血管外科杂志（电子版）》2017年第1期32-36,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：安徽省自然科学基金项目(1408085MH177)

摘　　要：目的探讨内脏动脉瘤(VAA)的合理治疗方式。方法回顾性分析2006年1月至2016年9月在安徽省立医院血管外科诊治的41例VAA患者,其中脾动脉瘤24例,肾动脉瘤7例,肝动脉瘤4例,腹腔干动脉瘤4例,肠系膜上动脉瘤1例,多发动脉瘤1例,并对其治疗方法及结果进行分析。结果22例行手术治疗,1例脾动脉瘤破裂患者在准备手术过程中发生二次破裂而死亡,18例未手术,首次手术成功率91.3%(21/23),二次手术成功率95.7%(22/23)。所有患者随访1~36(平均14.7)个月,22例手术患者中1例术后1个月出现脾梗死,余患者术后均无动脉瘤破裂、出血及复发;未手术18例,其中1例3个月后脾动脉瘤破裂导致死亡,3例合并恶性肿瘤患者分别在5、13、15个月后死亡,余患者随访期间均无动脉瘤破裂、出血及增大。结论 VAA的治疗需要综合考虑实际情况选择合适的治疗手段,开放手术与腔内治疗均能取得良好效果,未手术者应密切随访。Objective To discuss the proper treatments for visceral artery aneurysms(VAA).Methods A retrospective analysis was made on 41 patients with VAA that was hospitalized in vascular surgery of Anhui Provincial Hospital.Among these patients,there were 24 cases of splenic artery aneurysms,7 cases of renal artery aneurysms,4 cases of hepatic artery aneurysms,4 cases of celiac aneurysms,1 case of superior mesenteric artery aneurysm,and 1 case of multiple aneurysms.Their treatment methods and results were analyzed.Results Twenty-two cases underwent surgical treatment,1 patient with splenic artery aneurysm rupture died from secondary rupture during the surgery preparation process,and 18 cases did not receive operation.The primary technical success rate was 91.3%(21/23) at the first operation,and the secondary success rate was 95.7%(22/23).All patients were followed up for 1 ~36 months(average of 14.7months),22 patients who received surgery did not have artery aneurysm rupture,bleeding or recurrence,though 1 of them got splenic infarction in one month after operation;among the 18 patients who did not receive surgery,1 case died of splenic artery aneurysm rupture after 3 months,3 cases who complicated with malignant tumors died in 5,13 and 15 months;other patients had no artery aneurysm rupture,bleeding or enlargement during the follow-up.Conclusion Proper treatment methods should be selected for VAA based on its actual condition.Both open surgery and endovascular treatment can achieve a good outcome while nonsurgery patients should be followed up closely.

关 键 词：内脏动脉瘤 开放手术 血管腔内治疗 

分 类 号：R654.3[医药卫生—外科学]