主动脉移植物感染合并主动脉食管瘘的临床表现及预后  

Clinical manifestation and prognosis of aortic graft infection complicated with aortic esophageal fistula

作　　者：彭明亮 刘浩 张道琴 杨呈伟 刘巍 孙立忠 黄连军 PENG Mingliang;LIU Hao;ZHANG Daoqin;YANG Chengwei;LIU Wei;SUN Lizhong;HUANG Lianjun(Department of Interventional Therapy,Deltahealth Hospital Shanghai,Shanghai 201702,China)

机构地区：[1]上海德达医院介入治疗科,201702 [2]上海德达医院心脏大血管外科,201702

出　　处：《心肺血管病杂志》2022年第3期270-274,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨主动脉移植物感染(AGI)合并主动脉食管瘘(AEF)的病因、诊断、治疗方式及预后,以提高对该病的认识,争取早期诊断及治疗。方法:对2019年2月至2021年9月,上海德达医院主动脉移植物感染合并主动脉食管瘘病12例资料进行回顾性分析,并结合文献对该病的病因、诊断、治疗方式及预后进行总结。结果:共纳入病例12例,其中男11例、女1例,平均年龄47岁(23~60岁)。经胃镜或CT检查疾病诊出率为100%。首发临床表现为主动脉移植物感染后出现主动脉食管瘘的8例(66.7%),首发表现为主动脉食管瘘再表现主动脉移植物感染的4例(33.3%)。总死亡率高达50.0%(6例),外科手术7例,其中存活存活5例(71.4%);非外科手术5例,存活1例(25.0%)。结论:对存在主动脉移植物的患者如出现发热、呕血、吞咽困难等症状,应高度怀疑主动脉移植物感染合并主动脉食管瘘,应尽快完善相关检查,明确诊断并积极采取外科手术治疗,以提高生存及生命质量。Objective:To investigate aortic graft infections(AGI)complicated with aortic esophageal fistula(AEF)to improve the understanding of the disease and strive for early diagnosis and treatment.Methods:The data of AGI complicated with AEF in Shanghai Delta hospital from February 2019 to September 2021 are retrospectively analyzed,and the etiology,diagnosis,treatment and prognosis of the disease are analyzed in combination with the literature.Results:A total of 12 cases are included,including 11 males and 1 female,with an average age of 47 years(23-60 years).The diagnosis rate of diseases by gastroscope or CT is 100%.The first clinical manifestation is AEF after aortic graft infection in 8 cases(66.7%),and the first manifestation is AEF fistula and then aortic graft infection in 4 cases(33.3%).The overall mortality is as high as 50.0%(6 cases),7 cases underwent surgical operation,of which 5 cases survived(71.4%);5 cases underwent non-surgical operation,1 case survived(25.0%)Conclusions:For patients with aortic grafts,if they have symptoms such as fever,haematemesis,and dysphagia,aortic graft infection complicated with AEF should be highly suspected.Relevant examinations should be improved as soon as possible,diagnosis should be made clear and surgical treatment should be actively taken.Surgical treatment can improve the survival rate and the quality of life.

关 键 词：主动脉移植物感染 主动脉食管瘘 吞咽困难 呕血 

分 类 号：R54[医药卫生—心血管疾病]