主动脉瘤腔内隔绝术后系统性炎症反应综合征

SYSTEMIC INFLAMMATORY RESPONSE SYNDROME AFTER ENDOVASCULAR GRAFT EXCLUSION FOR AORTIC ANEURYSM OR AORTIC DISSECTION

为探讨主动脉瘤腔内隔绝术后全身炎症反应发病机制及防治措施 ,对经历了成功的主动脉腔内隔绝术 (移植物为Z型记忆合金支架与涤纶人工血管复合体 )的 38例腹主动脉瘤、2 9例胸主动脉夹层动脉瘤患者进行了回顾性研究。所有患者术后都进行体温 (T)、外周血白细胞 (WBC)及血小板监测 ,体温超过 38 5℃者进行了常见的术后感染源等检测。结果发现 ,所有患者术后均发生不同程度的发热、WBC增高及血小板减少 ,1～ 2周后基本恢复正常 ,全身未检测到任何感染源 ;术后 1～ 6月均无移植物感染或出血、血栓栓塞等表现。短期随访结果表明 ,主动脉瘤腔内隔绝术后发热。

To explore the pathogenesis and treatment of fever, leukocytosis and thrombocytopenia after endovascular graft exclusion for aortic aneurysm or aortic dissection, 67 patients with infrarenal aortic aneurysm (38) and thoracic aortic dissection (29),were studied,and then received successful endovascular graft exclusion with Dacron covered stent grafts. Sepsis syndrome evaluation (physical examination, analysis of peripheral blood WBC, platelet and urine, chest radiograph, urine and blood cultures) was performed for all patients with postoperative temperature(T) higher than 38 5℃. Fever, leukocytosis and thrombocytopenia in peripheral blood were found in most patients, whose T, WBC and platelet returned to normal between 1 and 2 weeks. Sepsis evaluations failed to identify any source of infection in all patients. These results showed that fever and leukocytosis after endovascular stent graft repair for aortic aneurysm are resulted from systemic inflammatory response syndrome.