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[腹主动脉瘤破裂:从急救到手术室。观念的转变]

[Ruptured aneurysms of the abdominal aorta: from the First Aid to the Operating Room. Changing concepts].

作者信息

Frego Mauro, Bianchera Giorgio, Angriman Imerio, Norberto Lorenzo, Pilon Fabio, Polese Lino, Scarpa Marco, Ruffolo Cesare, Corso Stefano, De Zolt Patrizia

机构信息

Clinica Chirurgica I, Università degli Studi di Padova.

出版信息

Ann Ital Chir. 2007 Jul-Aug;78(4):277-81.

Abstract

Worldwide literature review from PubMed indicate that progress has been made in first aid assistance, diagnosis and treatment of ruptured abdominal aortic aneurysms, which led to a reduced operative mortality. Nevertheless, ruptured aneurysms may present atipically in about half of the cases, thus leading to an initially uncorrect diagnosis up to 25% of cases. Mean survival interval from onset of symptoms and death is 10-14 hours, thus indicating that time exists to consider the new imaging techniques in 80% of patients, particularly the TC multislice. This, when is strategically located close to the emergency or the operative room, can rapidly allow a correct diagnosis and provide an accurate morphological evaluation, thus enabling the surgeon to plan the most adequate treatment with open or endovascular repair.

摘要

来自PubMed的全球文献综述表明,在腹主动脉瘤破裂的急救、诊断和治疗方面已取得进展,这导致手术死亡率降低。然而,约一半的破裂动脉瘤可能表现不典型,因此在高达25%的病例中最初诊断错误。从症状出现到死亡的平均存活间隔为10 - 14小时,这表明在80%的患者中有时间考虑采用新的成像技术,特别是多层螺旋CT。如果将其战略性地安置在靠近急诊科或手术室的位置,就能迅速做出正确诊断并提供准确的形态学评估,从而使外科医生能够规划最恰当的开放或血管腔内修复治疗方案。

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