摘要
目的探讨孤立性髂动脉瘤(solitary iliac aneurysms,SIA)的诊治方法。方法回顾性分析1985年1月至2008年1月23年间19例SIA患者的临床资料。其中,男性18例,女性1例,年龄39—77岁,平均(62±7)岁。19例患者中16例行择期动脉瘤切除、人工血管移植,1例行腔内修复术,1例破裂性SIA急诊行动脉瘤切除、人工血管移植,1例破裂性SIA未手术即死亡。结果19例患者共有30个SIA,其中25个(83.3%)位于髂总动脉,4个(13.3%)位于髂内动脉,1个(3.3%)髂外动脉瘤。11例(57.9%)患者具有多发性动脉瘤,其中9例(47.4%)为双侧髂动脉瘤,另2例合并其他部位的动脉瘤。2例(10.5%)合并动脉闭塞性疾病。2例破裂SIA,1例抢救成功,1例抢救无效死亡。开腹手术的17例患者无围手术期死亡,无盆腔脏器缺血等并发症;1例腔内修复术治疗后无内漏等并发症。术后移植血管通畅,无新发动脉瘤形成。结论早期诊断和治疗SIA非常重要,应通过CTA等方法明确诊断及有否合并多发性动脉瘤或动脉闭塞性疾病。SIA的手术效果良好,术后应长期随访,注意有否吻合口动脉瘤或新生动脉瘤。
Objective To reporl our surgical experience in treating 19 cases of solitary iliac aneurysms (SIA). Methods The clinical data of 19 consecutive patients with SIA between January 1985 and January 2008 were retrospectively reviewed. There were 18 men and 1 woman, aging from 39 to 77 years ( mean 62 ± 7 years). Results There were 30 SIAs in the 19 patients, including 25 (83.3%) common iliac aneurysms, 4 (13.3%) internal iliac aneurysms and 1 (3.3%) external iliac aneurysm. Eleven patients (57. 9% ) had multiple aneurysms, with 9 patients (47.4%) having bilateral SIA. Two patients had coexistent peripheral vascular occlusive disease. There were 2 patients suffering form ruptured SIA, one was saved by emergency operation and one died before an surgery could be attempted. Seventeen patients underwent successful open aneurysmectomy and artificial graft implantation leaving no ischemic complications of the pelvic organs. One patient with right common iliac aneurysm underwent endovascular repair without endoleak. There was no operative death during perioperative period. The surviving patients remained stable and had good patency of grafts during the follow-up period. Conclusions Early management of SIA is important, CT angiogarphy (CTA) is necessary not only to evaluate the SIAs, but also to detect multiple aneurysms or arterial occlusive disease. Close and long-term follow-up is mandatory for the early detection of the formation of new aneurysms.
出处
《中华普通外科杂志》
CSCD
北大核心
2009年第1期5-7,共3页
Chinese Journal of General Surgery
关键词
髂动脉瘤
血管外科手术
诊断
Iliac aneurysm
Vascular surgical procedures
Diagnosis