Department of Vascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
Department of Vascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
Int J Surg. 2016 Dec;36(Pt A):104-108. doi: 10.1016/j.ijsu.2016.10.028. Epub 2016 Oct 20.
To study the beneficial place for the treatment of ruptured abdominal aortic aneurysms (RAAAs).
A retrospective chart review of consecutive RAAA patients was performed. Patients were divided into two groups: direct group and transfer group. We retrospectively reviewed patients' hospital charts and recorded various clinical factors apparent on presentation. The primary consequence was mortality during hospitalization, and some other parameters such as duration of intensive care unit (ICU). All patients were followed up at 1 month, 3 months, 6 months and one year after discharge.
During 4-year period, 56 RAAA patients were treated (24 in direct group, and 32 in transfer group). Significant differences were shown for systolic blood pressure, pulse oxygen saturation, hemoglobin, the time interval from diagnosis to operation et al. There was no difference concerning age and comorbidity among two groups. All the patients were treated by open surgical aneurysm repair. The mortality rate was 68.8% ((6 + 16)/32) in transfer group and 33.3% (8/24) in direct group (P = 0.00067). Both the duration of ICU stay and entire hospitalization were a bit longer in the transfer group, but there was no significant difference. The mean follow-up time was 25.2 ± 12.9 months. The cumulative survival difference was significant (P = 0.042) between the two groups.
It is beneficial that we treat RAAAs in the diagnosed hospital. The reasons are: 1) to avoid the development of unstable state of aneurysm after rupturing of stable state; 2) the time interval from initial symptoms to operation will be shortened.
研究治疗破裂性腹主动脉瘤（RAAA）的有益之处。
对连续 RAAA 患者进行回顾性图表审查。患者分为两组：直接组和转院组。我们回顾性地查阅了患者的病历，并记录了就诊时出现的各种临床因素。主要结果是住院期间的死亡率，以及其他一些参数，如重症监护病房（ICU）的持续时间。所有患者在出院后 1 个月、3 个月、6 个月和 1 年进行随访。
在 4 年期间，共治疗了 56 例 RAAA 患者（直接组 24 例，转院组 32 例）。两组在收缩压、脉搏血氧饱和度、血红蛋白、从诊断到手术的时间间隔等方面存在显著差异。两组在年龄和合并症方面无差异。所有患者均接受开放手术动脉瘤修复。转院组死亡率为 68.8%（（6+16）/32），直接组为 33.3%（8/24）（P=0.00067）。转院组 ICU 停留时间和整个住院时间略长，但无统计学差异。平均随访时间为 25.2±12.9 个月。两组间累积生存率差异有统计学意义（P=0.042）。
在诊断医院治疗 RAAA 是有益的。原因是：1）避免动脉瘤破裂后从稳定状态向不稳定状态发展；2）从初始症状到手术的时间间隔将缩短。
