布氏杆菌感染性主动脉瘤腔内治疗效果分析

Analysis of the clinical effect of endocascular repair of Brucella-infected abdominal aortic aneurysm

目的:分析布氏杆菌感染性腹主动脉瘤的临床特点、腔内治疗安全性和有效性。方法:回顾性分析2019年1月至2022年11月,宁夏回族自治区人民医院心脏大血管外科收治的13例布氏杆菌感染性腹主动脉瘤患者的临床资料,其中术前5例术前合并腹主动脉破裂、2例合并髂动脉破裂,13例均行腔内修复术,术后均接受长期抗菌药物治疗。术后对患者进行1~40个月随访,观察腔内修复术的安全性及有效性。结果:围术期13患者无死亡,4例同期行髂内动脉弹簧圈栓塞术,恢复良好。1例患者术后20个月复发,出现感染性休克再次入院治疗。结论:布氏杆菌感染性腹主动脉瘤发病率虽然较低,部分患者常呈重症,破裂风险高,规范的抗菌药物治疗联合覆膜支架血管腔内修复术是安全、有效的。

Objective:To analyze the clinical characteristics,safety and effectiveness of endovascular repair of abdominal aortic aneurysm infected with Brucella.Methods:Retrospective analysis was made on the clinical data of 13 patients with Brucella infected abdominal aortic aneurysm admitted to the Department of Cardiovascular Surgery of the People's Hospital of Ningxia Hui Autonomous Region from January 2019 to November 2022.Among them,5 patients had abdominal aortic rupture before operation,2 patients had iliac artery rupture,13 patients had endovascular repair,and all received long-term antibiotic treatment after operation.The patients were followed up for 1-40 months to observe the safety and effectiveness of endovascular repair.Results:During the perioperative period,13 patients did not die,and 4 patients received coil embolization of internal iliac artery at the same time,with good recovery.One patient relapsed 20 months after operation and was hospitalized again with septic shock and sepsis.Conclusions:Although the incidence rate of Brucella infected abdominal aortic aneurysm is low,some patients are often severe,and the risk of rupture is high.Standardized antimicrobial therapy combined with covered stent endovascular repair is safe and effective.