高原地区腹主动脉瘤手术可行性及预后危险因素分析  

Prognostic factors of surgical therapy for abdominal aortic aneurysm in the area of Tibet plateau

作　　者：普布次仁[1] 郑雷 苗雨晴 索朗达杰 Pubuciren null;Zheng Lei;Miao Yuqing;Suolangdajie null(Department of General Surgery,People's Hospital of Tibet Autonomous Region,Lahsa 850000,China;Department of Urology,People's Hospital of Tibet Autonomous Region,Lahsa 850000,China;Department of Vascular Surgery,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]西藏自治区人民医院普外科,拉萨850000 [2]西藏自治区人民医院泌尿外科,拉萨850000 [3]北京医院国家老年医学中心血管外科,100730

出　　处：《中华普通外科杂志》2021年第9期681-683,共3页Chinese Journal of General Surgery

摘　　要：目的:回顾性分析西藏高原腹主动脉瘤患者外科开放手术治疗的可行性及影响患者预后的危险因素。方法:回顾性分析2013年6月至2017年12月在西藏自治区人民医院收治的48例确诊为腹主动脉瘤患者的临床及随访资料。结果:5例主动脉瘤破裂保守治疗患者均死亡。8例放弃治疗,自动出院者随访中5例最终死于动脉瘤破裂。35例行外科手术治疗的患者技术成功率100%,围手术期并发症发生率5.7%,输血率为11.4%,无围手术期死亡。术后患者随访2个月至5年,3例死亡。单因素回归分析结果显示慢性高原红细胞增多症是手术预后不良的危险因素(P<0.05)。结论:在西藏地区,传统的外科手术是治疗腹主动脉瘤的安全、有效的手段。慢性高原红细胞增多症是手术预后不良的危险因素。Objective To analyze the feasibility of surgical therapy and the risk factors affecting prognosis for patients with abdominal aortic aneurysms in Tibetan plateau.Methods Data of 48 abdominal aortic aneurysm cases were retrospectively analyzed at our hospital from Jun 2013 to Dec 2017.Results Five cases received conservative treatment for suspected rupture of abdominal aortic aneurysm and all died.Eight cases left hospital without treatment,among them 5 cases died for rupture of abdominal aortic aneurysm.Thirty-five patients had abdominal aortic aneurysm resection and artificial vascular reconstruction.Successful rate was 100%.Perioperative complications developed in 5.7%patients;blood transfusion rate was 11.4%,there were non-perioperative death.Single-factor regression analysis showed that chronic altitude erythrocytosis as an independent risk factor with poor surgical prognosis(P<0.05).Conclusion Even in Tibet plateau,traditional surgery is a safe and effective method for treating abdominal aortic aneurysms.Chronic altitude erythrocytosis is an independent risk factor for poor surgical prognosis.

关 键 词：主动脉瘤 腹 血管外科手术 预后 危险因素 西藏高原地区 

分 类 号：R654.3[医药卫生—外科学]