破裂腹主动脉瘤的外科救治体会

Experience in management for ruptured abdominal aortic aneurysm

目的探讨破裂腹主动脉瘤(RAAA)外科救治经验。方法回顾性分析1999年4月至2008年12月救治的38例RAAA患者的临床资料,根据病史、体征、急诊彩超和CT快速诊断,行急诊腹主动脉瘤切除人造血管移植手术。结果均行急诊RAAA切除人造血管移植手术,围手术期死亡10例(26.3%),其中出血性休克所致急性肾功能衰竭4例,多器官功能衰竭4例,呼吸循环衰竭2例;其他28例患者经治疗后均痊愈出院。结论快速早期确定RAAA诊断,紧急外科手术治疗,尽快纠正失血所致内环境紊乱是提高RAAA救治成功的关键。

Objective To explore the experience of diagnosis and surgical treatment of ruptured abdominal aortic aneurysm(RAAA).Methods The data of 38 cases with RAAA who underwent urgently diagnosis and surgical repair of graft replacement from April 1999 to December 2008 were analyzed retrospectively.Results During the perioperative period,10 out of 38 cases(26.3%) died of acute renal failure(n=4),multiple organ failure(n=4) and respiratory failure(n=2),respectively.Other 28 cases discharged.Conclusion Rapid and early diagnosis,urgent surgical repair of RAAA and rapid correction of internal environment disorder caused by blood loss may play important roles in reducing the mortality of RAAA.