类鼻疽感染性腹主动脉瘤13例临床分析  

Clinical analysis of infected abdominal aortic aneurysms caused by Burkholderia pseudomallei:a report of 13 cases

作　　者：吴鸿飞[1] 曾昭凡[1] 戚悠飞[1] 肖占祥[1] Wu Hongfei;Zeng Zhaofan;Qi Youfei;Xiao Zhanxiang(Department of Vascular Surgery,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南省人民医院海南医学院附属海南医院血管外科,海口570311

出　　处：《中国血管外科杂志（电子版）》2020年第2期97-100,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的分析类鼻疽感染性腹主动脉瘤患者的临床特征、治疗及预后。方法回顾性分析海南省人民医院2010年10月至2019年9月收治的13例类鼻疽感染性腹主动脉瘤患者的临床资料。结果 12例患者有明确农田接触史,住院期间静脉抗感染(23.2±17.3)d,院外口服抗感染(8.6±6.1)个月。7例患者行开放手术,5例行EVAR,1例单纯抗感染治疗。围术期2例患者开放手术后分别因肠瘘、腹腔出血再次手术;1例支架感染,取出支架后行双侧腋-股动脉转流术;2例患者死亡。患者平均随访25.3(3~60)个月,腋-股动脉转流患者术后2个月右侧人工血管血栓形成,术后6个月左侧血栓形成;1例EVAR术后3年感染症状未控制。结论类鼻疽感染性腹主动脉瘤患者多有湿润土壤接触史,病情比较复杂,足量的抗感染治疗是基础,合适的外科手术能降低病死率。Objective To explore the clinical characteristics,treatment and outcomes of patients with infected abdominal aortic aneurysms caused by Burkholderia pseudomallei(BP).Methods The clinical data of 13 patients with infectious abdominal aortic aneurysms caused by BP in Hainan General Hospital from October 2010 to September 2019 were analyzed retrospectively.Results Twelve patients had a clear history of farmland exposure.Patients received intravenous anti-infection for(23.2±17.3)days in the hospital,and oral anti-infection(8.6±6.1)months outside hospital.Among them,seven patients underwent open surgery,five patients underwent endovascular aortic repair(EVAR),and one patient received conservative treatment.During the perioperative period,two patients underwent reoperation due to intestinal fistula and abdominal bleeding after open surgery and one patient of stent infection underwent bilateral axillary-femoral artery bypass surgery after removal of the stent.Two patients died.The average follow-up time was 25.3(3~60)months.The patient with axillary-femoral artery bypass thrombosis at the right vascular prosthesis two months after surgery,and thrombosis at the left six months after surgery.One patient occurred uncontrolled infection three years after EVAR.Conclusion Patients with infectious abdominal aortic aneurysms caused by BP have mostly history of contact with moist soil.The condition is complicated and adequate antibiotic therapy is the foundation,and proper surgery can reduce mortality.

关 键 词：类鼻疽 伯克霍尔德菌 腹主动脉瘤 感染 

分 类 号：R654.3[医药卫生—外科学]