急性腹主动脉闭塞的外科治疗及肌病肾病代谢综合征的防治

The management and prevention of acute abdominal aortic occlusion and myonephropathic metabolic syndrome

目的 总结急性腹主动脉闭塞及其并发症肌病肾病代谢综合征的诊治经验。方法 回顾性分析 1987年 8月至 2 0 0 3年 8月间治疗急性腹主动脉闭塞 32例 ,其中手术治疗 30例 ,未手术治疗 2例。结果 32例中死亡 13例。手术组死亡 11例 ( 34 6 % )。术后急性肾功能衰竭、代谢性酸中毒及高钾血症是死亡的主要原因。肢体保存率 78 9%。结论 急性腹主动脉闭塞一旦确诊 ,应尽早治疗 ,最大程度地缩短发病至手术的时间。肌病肾病代谢综合征是急性腹主动脉闭塞的常见、严重并发症 ,其有效防治是急性腹主动脉闭塞治疗成功与否的关键因素之一 。

Objective: To summarize the experience in the management of acute abdominal aortic occlusion and myonephropathic metabolic syndrome. Methods: Thirty two cases of acute abdominal aortic occlusion treated between Aug. 1987 and Aug. 2003 in this department were analyzed retrospectively. Results: There were 11 deaths in surgical group (36 6%), mainly due to acute renal failure, metabolic acidosis and hyperkalemia postoperatively. Conclusion: Acute abdominal aortic occlusion is a potentially lethal disease, which would lead to limb. Early diagnosis and surgical restoration of aortic circulation might be helpful decrease the morbidity and mortality. The effective management of myonephropathic metabolic syndrome (MNMS), a common and severe complication of AAO would have a great impact on the therapeutic outcome. However, the mechanism, prevention and treatment of this syndrome further study.