摘要
目的总结腹主动脉瘤破裂（ruptured abdominal aortic aneurysm，RAAA）急诊手术的治疗经验。方法回顾性分析25例RAAA急诊救治过程，并与同期完成的48例择期腹主动脉瘤（abdominal aortic aneurysm，AAA）切除术在输血量、ICU住院天数、瘤体最大直径和死亡率等指标分别进行统计分析比较。结果RAAA急诊手术与择期AAA切除术患者比较，围手术期输血量（2980±2712）ml和（580±314）ml；ICU住院天数（6．8±5．7）d和（2．5±1．5）d；手术死亡率32％（8／25）和2．1％（1／48），差异均有统计学意义（P〈0．01）；瘤体直径（5．9±1．4）cm和（5．3±1．4）cm者差异无统计学意义（P〉0．05）；术后并发症有：脑卒中、肾功能衰竭、成人呼吸窘迫综合征和消化道出血。结论AAA一经发现，应选择尽早择期手术，合理的抢救措施有助于降低RAAA手术死亡率。
Objective To summarize the experiences of diagnosis and treatment on ruptured abdominal aortic aneurysm （RAAA）. Methods Twenty five RAAA cases undergoing emergency surgery were analyzed retrospectively. Blood transfusion, postoperative ICU stay, the size of aneurysm, and mortality rate were respectively compared with that of 48 AAA cases undergoing selective conventional aortic surgery. Results In emergency group and selective group, blood transfusion was （2980 ± 2712 ） ml and （580 ± 314） ml,P〈0.01; ICU stay was （6.8 ±5.7） d and （2.5 ± 1.5） d （P 〈0.01） respectively;Operative mortality was 32% （8/25）, and 2. 1% （ 1/48 ） （P 〈 0. 01 ） respectively; AAA size was （5.9 ± 1.4） cm and （5. 3 ± 1.4） cm （P 〉 0. 05 ） respectively. Postoperative complications included stroke, renal dysfunction, ARDS and GI bleeding. Conclusion Surgery should be performed once abdominal aortic aneurysm was diagnosed, active resuscitation measures are conducive to decreasing postoperative mortality.
出处
《中华普通外科杂志》
CSCD
北大核心
2007年第8期594-596,共3页
Chinese Journal of General Surgery
关键词
主动脉瘤
腹
动脉瘤
破裂
血管外科手术
Aortic aneurysm,abdominal
Aneurysm,ruptured
Vascular surgical procedures
