Norwood M G A, Polimenovi N M, Sutton A J, Bown M J, Sayers R D
Department of Surgery, University of Leicester, Leicester, UK.
Eur J Vasc Endovasc Surg. 2004 Mar;27(3):287-91. doi: 10.1016/j.ejvs.2003.12.004.
To assess the outcome of AAA repair in patients with established renal failure (RF), including patients on dialysis.
Retrospective case-control study in a teaching hospital. Methods. All patients with established RF undergoing AAA repair were identified during the last eight years. Data was collected from patient notes on operative difficulty, hospital mortality, survival time and future dialysis requirements. For comparison, 28 consecutive patients undergoing AAA repair without RF were studied prospectively.
Thirteen RF patients were identified. Three were receiving Continuous Ambulatory Peritoneal Dialysis (CAPD), three were receiving Haemodialysis (HD) and seven had established RF, but were not receiving dialysis. Compared with the control patients, RF patients had a longer total hospital stay (p=0.03, 95% CI for median stay -24.3 to -4.0 days), more postoperative complications (p<0.01, 95% CI 26.4-73.7%) and had an increased in-hospital mortality (p=0.02, 95% CI 4.6-54.3%). Four of the six survivors who were non-dialysis-dependent required long-term dialysis postoperatively.
AAA repair in RF patients is associated with increased postoperative morbidity and mortality. Previously non-dialysis-dependent patients have a high risk of subsequent long-term dialysis.
评估已确诊肾衰竭（RF）患者（包括接受透析的患者）腹主动脉瘤修复术的治疗结果。
在一家教学医院进行的回顾性病例对照研究。方法。确定过去八年内所有接受腹主动脉瘤修复术的已确诊RF患者。从患者病历中收集有关手术难度、医院死亡率、生存时间和未来透析需求的数据。为作比较，对连续28例未患RF而接受腹主动脉瘤修复术的患者进行前瞻性研究。
确定了13例RF患者。3例接受持续性非卧床腹膜透析（CAPD），3例接受血液透析（HD），7例已确诊RF但未接受透析。与对照患者相比，RF患者的总住院时间更长（p = 0.03，中位住院时间的95%可信区间为-24.3至-4.0天），术后并发症更多（p<0.01，95%可信区间为26.4 - 73.7%），住院死亡率增加（p = 0.02，95%可信区间为4.6 - 54.3%）。6例非透析依赖的幸存者中有4例术后需要长期透析。
RF患者的腹主动脉瘤修复术与术后发病率和死亡率增加有关。以前非透析依赖的患者后续长期透析风险高。
