胸、腹主动脉瘤破裂手术治疗(附8例报告)

SURGERY FOR RUPTURED THORACO-ABDOMINAL AORTIC ANEURYSM: A REPORT OF EIGHT CASES

①目的 总结胸、腹主动脉瘤破裂 (RAAA)诊治经验。②方法 回顾性分析 8例RAAA病人。肾动脉上段RAAA 3例 ,1例胸腹联合切口 ,2例腹部切口 ,均采用Crowford方法吻合。 5例肾动脉下段RAAA行传统腹部切口手术。③结果 手术后 1月内死亡和长期生存均为 3例。术后并发症有 :脑卒中、肾衰竭、成人型呼吸窘迫综合征 (ARDS)和消化道出血。④结论 减少围手术期输血量、纠正休克、缩短病人等待手术时间、选择适当的麻醉及手术方法、改善凝血功能障碍、预防出血、纠正肾衰竭和ARDS等措施 ,均有助于降低RAAA的手术病死率。控制感染。

Objective\ To summarize the experience of diagnosis and treatment of ruptured abdominal aortic aneurysm (RAAA). \ Methods\ Eight patients with RAAA were analyzed retrospectively. In which, three cases with suprarenal aortic aneurysm, one through thoraco abdominal incision and two through abdominal, were operated with Crowfords procedure. Five with infrarenal one by conventional abdominal approach.\ Results\ The surgical mortality (within one month after surgery) and long term survival were three for each group. The surgical complications included: stroke, renal failure, ARDS and hemorrhage of digestive tract.\ Conclusion\ Control of blood transfusion, correction of shock, shortening of time waiting for operation, selection of suitable anesthesia and surgery, improving blood coagulation; prevention of hemorrhage, correction of renal failure and ARDS are conducive to reduce the mortality. Prevention of infections, correction of acid base disturbance and negative nitrogen balance are also important links during peri operative phase.