高危患者腹主动脉瘤的外科治疗。

Y Morishita, H Toyohira, T Yuda, M Yamashita, S Shimokawa, H Saigenji, M Hashiguchi, S Kawashima, Y Moriyama, A Taira
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引用次数: 1

摘要

为了确定术前可预测的影响动脉瘤切除术后死亡率的危险因素,本研究回顾了连续110例接受选择性切除术的腹主动脉瘤患者的手术治疗。本研究增加的术前风险包括肺功能不全、肾功能不全、80岁以上高龄、缺血性心脏病以及相关的其他疾病,如胸动脉瘤、四肢动脉粥样硬化和恶性肿瘤。46例患者有其中一种危险因素(一风险组),17例有两种(二风险组),9例有三种(三风险组)。高风险患者的手术死亡率为4.2%,无风险患者的手术死亡率为0%。随着危险因素的增加,动脉瘤修复术与手术死亡率增加有关;风险一组2.2%,风险二组5.9%,风险三组11.1%。动脉瘤切除术后死亡的常见危险因素是肺功能不全,导致辅助通气时间延长。因此,对高危患者,特别是肺功能不全患者的最佳治疗可能会降低动脉瘤切除术后的死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical treatment of abdominal aortic aneurysm in the high-risk patient.

In an attempt to define the preoperative risk factors that predictably influence mortality after aneurysmectomy, this study reviews the surgical management of abdominal aortic aneurysms in a series of 110 consecutive patients who underwent elective resection. The preoperative risks to be added to the present study included pulmonary insufficiency, renal dysfunction, advanced age of over 80 years, ischemic heart disease, and associated other diseases such as thoracic aneurysms, atherosclerosis of the limbs and malignant tumors. Forty-six patients had one of these risk factors (one-risk group), 17 had two (two-risk group), and 9 had three (three-risk group). The operative mortality rates were 4.2 per cent for the high-risk patients and 0 per cent for the patients at no risk. As the number of risk factors increased, aneurysm repair was associated with an increased operative mortality; being 2.2 per cent in the one-risk group, 5.9 per cent in the two-risk group and 11.1 per cent in the three-risk group. The common risk factor in patients who died after aneurysmectomy was pulmonary insufficiency which induced prolonged periods of assisted ventilation. Thus, the optimal management of high-risk patients, particularly those with pulmonary insufficiency, may reduce the mortality after aneurysmectomy.

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