Durrani Noreen K, Trisal Vijay, Mittal Vijay, Hans S S
Department of Surgery, Providence Hospital Medical Center, Southfield, Michigan 48075, USA.
Am Surg. 2003 Apr;69(4):330-3; discussion 333.
Gastrointestinal complications after ruptured aortic abdominal aneurysm (AAA) repair are not well defined and are limited to descriptions of ischemic colitis. We sought to delineate risk factors predicting gastrointestinal complications after ruptured AAA repair. Data from 100 consecutive patients after ruptured AAA repair between July 1980 and June 2000 were gathered for multiple preoperative, intraoperative, and postoperative factors. These variables were analyzed relative to postoperative gastrointestinal complications and resulting mortality. Overall mortality was 48 per cent. Gastrointestinal complications were encountered 29 times in 27 patients of 100 total patients (27%). Complications included prolonged adynamic ileus (three), acute pancreatitis (four) and cholecystitis (two), perforated duodenal ulcer (one), bowel obstruction (three), antibiotic-associated colitis (six), ischemic colitis (three), bowel infarction (four), and liver failure (three). Comparison of patients with and without gastrointestinal complications showed no predictive preoperative or intraoperative variables. Gastrointestinal complications are common in ruptured aortic aneurysm repair and carry increased mortality and morbidity. Surgeons must maintain a high level of suspicion to anticipate possible gastrointestinal complications.
腹主动脉瘤（AAA）破裂修复术后的胃肠道并发症尚无明确定义，且仅限于对缺血性结肠炎的描述。我们试图明确预测AAA破裂修复术后胃肠道并发症的危险因素。收集了1980年7月至2000年6月期间100例连续接受AAA破裂修复术患者的术前、术中和术后多种因素的数据。分析这些变量与术后胃肠道并发症及由此导致的死亡率的相关性。总体死亡率为48%。100例患者中的27例（27%）出现了29次胃肠道并发症。并发症包括持续性动力性肠梗阻（3例）、急性胰腺炎（4例）和胆囊炎（2例）、十二指肠溃疡穿孔（1例）、肠梗阻（3例）、抗生素相关性结肠炎（6例）、缺血性结肠炎（3例）、肠梗死（4例）和肝功能衰竭（3例）。有胃肠道并发症和无胃肠道并发症患者的比较显示，术前或术中无预测变量。胃肠道并发症在腹主动脉瘤破裂修复术中很常见，且会增加死亡率和发病率。外科医生必须保持高度警惕，以预见可能的胃肠道并发症。
