Koga Yukari, Hara Masato, Mori Sawako, Miyawaki Nao, Mishima Yasunori, Kano Tatsuhiko, Ushijima Kazuo
Department of Anesthesiology, Kurume University School of Medicine, Kurume 830-0011.
Masui. 2011 Feb;60(2):195-8.
This retrospective study was performed to identify the perioperative factors affecting the mortality rate in 28 patients, who had received emergency surgery for ruptured abdominal aortic aneurysms from January, 2005 to June, 2008. Five (17.9%) of these 28 patients died of massive bleeding, sepsis, or multiple organ failure during or within 11 days after surgery. Various factors which might influence the outcomes were compared between the survivors and non-survivors. Preoperative hypotension defined as a systolic blood pressure < or = 80 mmHg associated with hemorrhagic shock was the only significant factor affecting the mortality. There were no significant differences in age, gender, the time from the admittance to the hospital to aortic cross clamping, duration of surgery, and the amount of blood products transfused and intraoperative blood loss, between the two groups. Of great importance is that preoperative hypotension should be corrected before the onset of hemodynamic deterioration.
本回顾性研究旨在确定2005年1月至2008年6月期间因腹主动脉瘤破裂接受急诊手术的28例患者围手术期影响死亡率的因素。这28例患者中有5例（17.9%）在手术期间或术后11天内死于大出血、败血症或多器官功能衰竭。对可能影响预后的各种因素在幸存者和非幸存者之间进行了比较。术前低血压定义为收缩压≤80 mmHg且伴有失血性休克，是影响死亡率的唯一显著因素。两组在年龄、性别、从入院到主动脉阻断的时间、手术持续时间、输血量和术中失血量方面均无显著差异。重要的是，应在血流动力学恶化之前纠正术前低血压。
