38例肾下型腹主动脉瘤开腹手术的临床体会

The Experience of Surgical Treatment of 38 cases of Abdominal Aortic Aneurysm

目的探讨腹主动脉瘤人工血管置换的治疗方法和经验。方法回顾性分析2013年4月-2019年10月台山市人民医院收治的38例AAA患者资料。结果所有患者均顺利完成手术,无术中死亡病例。手术时间:150~370 min,平均(260.2±63.4)min,术中出血量:300~1 500 mL,平均(571.6±284.2)mL,住院费用:23 000~70 000元,平均(52 000.1±10 394.9)元。术后死亡4例,其中3例为腹主动脉瘤破裂出血患者。术后8例术后肺部感染,5例出现急性肾功能异常,3例出现缺血性结肠炎,1例出现臀部肌肉缺血坏死,1例出现左下肢肢端缺血坏死。结论人工血管置换术远期疗效好,住院费用低,适合所有AAA患者,其在临床上仍然有实际应用价值,特别在基层医院或贫困患者中。

Objective To summarize the methods and experience of surgical treatment of abdominal aortic aneurysm. Methods The clinical data of 38 patients with abdominal aortic aneurysm treated in Taishan People’s Hospital from April 2013 to October 2019 were analyzed retrospectively.Results All patients were successfully completed surgery, no intraoperative death cases. Operation time: 150~370 min, average(260.2±63.4)min, intraoperative hemorrhage: 300~1 500 mL, average(571.6±284.2)mL, the costs: 23 000~70 000 Yuan,(52 000.1±10 394.9) Yuan. Postoperative death occurred in 4 patients, including 3 with ruptured abdomen alaortic aneurysm. There were 8 cases of postoperative pulmonary infection, 5 cases of acute renal dysfunction, 3 cases of ischemic colitis, 1 case of gluteal muscle necrosis, 1 case of left extremity necrosis. Conclusion Prosthetic vessel replacement has a good long-term curative effect, appears to be less expensive, suits all AAA patients. It still has practical application value,especially in Local Medical Institutions or poor patients.