65例腹主动脉瘤的诊断与治疗

The diagnosis and treatment of 65 patients with abdominal aortic aneurysm

目的 总结腹主动脉瘤 (AAA)的诊断和治疗经验。方法 回顾、分析 1980～ 1999年收治的 6 5例AAA患者 ,普通型 40例 ,破裂型 18例 ,炎症型 4例 ,感染型 3例。 6 4例行手术治疗 ,其中原位移植 6 2例 ,旁路架桥 2例。 1例炎症型行股动脉插管药物治疗。结果 5 7例获得临床治愈 ,随访1～ 12年 ,平均 5年 ,无动脉瘤复发、栓塞或假性动脉瘤发生 ,生活工作如常。死亡 7例 ,其中普通型手术 1例 (死亡率 2 5 0 % ) ,破裂型手术 6例 (死亡率 33 33% )。结论 腹部搏动性肿物伴有压迫或栓塞性症状是重要诊断依据 ,腹部B超可作为筛选检查项目 ,血管造影和螺旋CT检查可提供准确的影像学资料。根据动脉瘤的部位、类型和患者具体情况合理选择手术方案 ,可提高手术治愈率 ,降低死亡率和并发症的发生率。

Objective To summarize our experience of the diagnosis and treatment in patients with abdominal aortic aneurysm(AAA).[WT5”HZ]Methods [WT5”BZ]From 1980 to 1999 sixty five AAA patients were hospitalized with 40 cases of general type, 18 cases of rupture type,4 cases of inflammatory type and 3 cases of infective type. In situ artificial graft transplantation was performed in 62 cases and nonanatomy pathway in 2 cases. The remaining one with inflammatory type was treated by interventionel therapy.[WT5”HZ]Results [WT5”BZ]57 cases were cured and were followed up from 1 to 12 years without complications.Death occurred in 7 cases.[WT5”HZ]Conclusions [WT5”BZ]The abdominal pulsate mass should draw much attention. Ultrasound is the selected examination and DSA, helix CT are accurate image appliance. It can elevate the curative ratio and decrease the mortality through rational operation based on the location, type and individual condition of AAA patients.