肾下型腹主动脉瘤的外科治疗

    Surgical treatment of infrarenal abdominal aortic aneurysm

    • 摘要: 目的: 总结肾下型腹主动脉瘤(abdominal aortic aneurysms,AAA)外科治疗经验。方法: 对25例肾下型腹主动脉瘤分别行传统外科手术19例,腔内修复术4例,非手术治疗2例。结果: 23例施行手术,死亡2例,均为AAA破裂急诊手术者,其中1例术后死于多器官功能障碍综合征,1例术后死于呼吸道感染、急性呼吸窘迫综合征。另2例AAA破裂患者因病情危重未治病死。围手术期死亡率为8.7%,其中择期手术为0,急诊手术为50%。随访18例,随访时间3个月至6年,无动脉瘤复发,无吻合口假性动脉瘤,无吻合口破裂出血,手术后人工血管通畅。腔内修复术患者支架无移位,通畅,无肠缺血、无内漏发生。结论: 手术切除腹主动脉瘤疗效是满意、安全的。腔内治疗特别适用于高危患者。

       

      Abstract: Objective: To summarize surgical experience on undergoing open repair or endovascular treatment of infrarenal abdominal aortic aneurysm(AAA).Methods: Consecutive 25 patients with infrarenal AAA who were treated by traditional open operation(19 cases),endovascular treatment(4 cases) and non-surgical treatment(2 cases) were retrospectively reviewed.Results: Twenty-three patients were performed by operation,but 2 cases which were rupture AAA were died perioperatively due to multiple organ dysfunction syndrome(MODS),pulmonary infection and acute respiratory distress syndrome(ARDS),respectively.The other 2 rupture AAA cases whose situations were serious were died without further treatment.The perioperatively mortality was 8.7.Eighteen cases were followed-up from 3 months to 6 years,the mean duration was 3.6 years.No aneurysm recurred,no pseudo-aneurysm and no rupture bleed.The grafts were patent.Cases which underwent endovascular treatment were no stent migration,no intestine ischemic,no endoleak and the stentgrafts were patent.Conclusions: The efficacy of open operation of AAA is satisfactory and safe.Endovascular treatment is specially suit for high severe AAA patients.

       

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