肾下型腹主动脉瘤的外科治疗
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Surgical treatment of infra-renal abdominal aortic aneurysm
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    目的:总结26例肾下型腹主动脉瘤的手术治疗经验。方法:回顾性分析近5年多来手术治疗26例肾下型腹主动脉瘤的临床资料,全组26例,术前均经影像检查证实诊断。行择期手术21例,破裂型腹主动脉瘤急诊手术5例。26例均行腹主动脉瘤切除,人工血管重建术。结果:围手术期死亡2 例,均为急症手术患者,总病死率7.7%,急诊手术病死率40.0%。随访时间1~5年。术后1,3,5年生存率分别为96%,88%,75%。死亡原因均与腹主动脉瘤和手术无关。 结论:CTA检查是诊断腹主动脉瘤的可靠方法。手术治疗仍是治疗腹主动脉瘤的重要方法。瘤体直径不是决定手术的唯一指征。影响手术的危险因素主要是高龄、严重的心肺疾病和肾功能不全。

    Abstract:

    Abstract:Objective:To summarize our experience in the treatment of 26 cases of infra-renal abdominal aortic aneurysm(AAA). Methods:Clinical data of 26 patients with infra-renal AAA treated with open surgical repair in recent 5 years were retrospectively reviewed. The diagnosis of AAA in all the patients was confirmed by imaging examination.21 patients were operated electively.Of them 5 patients whose aneurysms ruptured before operation underwent emergency surgery.All of the 26 cases were treated by aneurysmectomy and prosthetic grafting. Results:Among the five patients whose aneurysms ruptured before operation,two died in perioperative period.There was no operative mortality in the other cases. The overall mortality rate was 7.7%, and the mortality rate of emergency operation was 40.0%.Tweenty-four patients were followed-up for 1 year to 5 years.The 1,3,and 5-year survival rates were 96%,88%and75% respectively.No death was caused by aneurysm or the operation during follow-up. Conclusions:CT angiography is a credible method in the diagnosis of AAA.The aneurysm diameter is not an absolute operative indication.Risk factors of open operation of AAA are old age,severe cardiopulmonary diseases, and renal dysfunction.Open surgery is still the primary treatment of AAA.

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张宏光 ,韩冰,陈学明.肾下型腹主动脉瘤的外科治疗[J].中国普通外科杂志,2006,15(12):8-907.
DOI:10.7659/j. issn.1005-6947.2006.12.008

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  • 在线发布日期: 2006-12-25