Chaillou P, Patra P, Chapillion M, Meresse S, Lescalie F, Enon B, Chevalier J M, Bourseau J C, Dupon H
Clinique Chirurgicale Thoracique Cardiaque et Vasculaire, Hôpital G. et R. Laënnec, Nantes.
J Chir (Paris). 1990 Jun-Jul;127(6-7):319-24.
114 patients aged over 75 underwent surgery for aneurysm of the infra-renal abdominal aorta in the University Teaching Hospitals in Nantes and Angers between 1979 and 1988. A retrospective study of these patients was performed to evaluate the immediate and long-term results. The mean age of the patients was 79 (+/- 4) years, the oldest being 94. 70% were men. Half of the patients underwent emergency or semi-emergency surgery (52 cases). Cardiovascular factors (in particular coronary insufficiency in 17% of cases) were the most common risk factors. In all cases grafting after laying open the aneurysm was performed, with an aorto-aortic graft in 32% of patients, an aorto-iliac graft in 37% or an aorto-bifemoral graft in 27% of patients. Combined intestinal revascularisation was performed in 10% of case either involving the inferior mesenteric artery or at least one internal iliac artery; renal revascularisation was performed in 3.5% of cases. 75% of patients underwent simple grafting. The mean duration of hospitalisation was 14 days (+/- 6), including a mean period of 7 days in ICU. 36 patients (31%) died in the first post-operative month. The mortality rate in patients who underwent emergency surgery for a complication of the aneurysm (essentially rupture) was 61% versus 6' for elective surgery. 96% of the patients who survived the first post-operative month were independent at the end of the study or at the time of their death.(ABSTRACT TRUNCATED AT 250 WORDS)
1979年至1988年间,114名75岁以上的患者在南特和昂热的大学教学医院接受了肾下腹主动脉瘤手术。对这些患者进行了回顾性研究,以评估近期和远期结果。患者的平均年龄为79(±4)岁,年龄最大的为94岁。70%为男性。一半的患者接受了急诊或半急诊手术(52例)。心血管因素(尤其是17%的病例存在冠状动脉供血不足)是最常见的危险因素。所有病例均在切开动脉瘤后进行了 grafting,32%的患者采用主动脉-主动脉 graft,37%的患者采用主动脉-髂动脉 graft,27%的患者采用主动脉-双股动脉 graft。10%的病例进行了联合肠道血运重建,涉及肠系膜下动脉或至少一条髂内动脉;3.5%的病例进行了肾血运重建。75%的患者接受了单纯 grafting。平均住院时间为14天(±6),其中在重症监护病房的平均时间为7天。36名患者(31%)在术后第一个月死亡。因动脉瘤并发症(主要是破裂)接受急诊手术的患者死亡率为61%,而择期手术患者的死亡率为6%。术后第一个月存活的患者中,96%在研究结束时或死亡时能够自理。(摘要截选至250词)