Szostek M, Krepski K, Małek A K, Pogorzelski R, Leszczyński J, Brzeziński T, Ostrowski T
Kliniki Chirurgii Ogólnej i Chorób Klatki Piersiowej, Akademii Medycznej w Warszawie.
Pol Merkur Lekarski. 1999 Oct;7(40):172-4.
Between 1992-1997 185 patients were treated in our Department because of abdominal aortic aneurysm (AAA). The aim of the study was the evaluation of frequency of hospital mortality (30 days) in patients treated because of AAA. One hundred forty eight (80%) patients were operated on and 37 (20%) were treated classically. The surgical group of 148 patients were divided into three parts: group I: 106 patients with asymptomatic AAA, group II: 24 patients with symptomatic AAA and group III: 18 patients with ruptured AAA. Straight graft was performed in 118 patients (79.7%) with hospital mortality rate 8.5% and bifurcated graft implanted in 30 patients with mortality rate 26.7%. Analysis of our material allowed to find that hospital mortality was in group I: 2.8%, group II: 20.8% and in group III: 55.6%. The main cause of deaths in patients from groups I and II was myocardial infarction and hypovolemic shock in group III. The most common postoperative general complications were cardiac and pulmonary and were significantly more often in group III (p < .05). Other not significantly registered postoperative complications as renal insufficiency were also more common in patients from group III. Analysis of our material revealed that patients with abdominal aortic aneurysm should be operated selectively, when aneurysm diameter reaches 50 mm, and optimal method is straight graft which allows to reduce to minimum postoperative complications.
1992年至1997年间，我院收治了185例腹主动脉瘤（AAA）患者。本研究旨在评估因腹主动脉瘤接受治疗患者的医院死亡率（30天）。148例（80%）患者接受了手术治疗，37例（20%）患者接受了传统治疗。148例手术患者分为三组：第一组：106例无症状腹主动脉瘤患者；第二组：24例有症状腹主动脉瘤患者；第三组：18例腹主动脉瘤破裂患者。118例患者（79.7%）进行了直型人工血管移植，医院死亡率为8.5%，30例患者植入了分叉型人工血管，死亡率为26.7%。对我们收集的资料进行分析后发现，第一组的医院死亡率为2.8%，第二组为20.8%，第三组为55.6%。第一组和第二组患者的主要死亡原因是心肌梗死，第三组是低血容量性休克。最常见的术后全身并发症是心脏和肺部并发症，第三组明显更常见（p <.05）。其他未显著记录的术后并发症如肾功能不全在第三组患者中也更常见。对我们收集的资料进行分析后发现，腹主动脉瘤患者应在动脉瘤直径达到50 mm时进行选择性手术，最佳方法是直型人工血管移植，这可以将术后并发症降至最低。
