Deutsch M, Holzinger C, Krisch B, Magometschnigg H, Fasol R, Zilla P, Schwarz C, Staudacher M
II. Chirurgische Universitätsklinik, Wien.
Wien Klin Wochenschr. 1989 Jan 20;101(2):66-9.
Between 1976 and 1987 93 patients with an infrarenal aortic aneurysm underwent surgical correction. In 62 patients the procedure was performed electively, whilst 13 displayed an unstable aneurysm and in 18 cases a ruptured aneurysm was present at operation. During the past 5 years the mortality was lowered to 2% in elective cases, whereas in cases of ongoing rupture only moderate improvement took place. The most frequent cause of a lethal outcome was pump failure of the heart (6 times), followed by renal insufficiency and haemorrhagic shock and bleeding complications. Among the non-lethal complications, relaparotomy on the basis of postoperative bleeding ranks first, followed by pulmonary insufficiency, peripheral emboli and partial ischemia of the spine. Resection of infrarenal aneurysms should be performed in the stable state of disease, since insufficiency of multiple vital organ systems increases the mortality by up to 20 fold.
1976年至1987年间,93例肾下腹主动脉瘤患者接受了手术矫正。其中62例为择期手术,13例动脉瘤不稳定,18例术中发现动脉瘤破裂。在过去5年中,择期手术的死亡率降至2%,而对于持续破裂的病例,仅取得了适度改善。致死的最常见原因是心脏泵衰竭(6次),其次是肾功能不全、失血性休克和出血并发症。在非致命并发症中,术后出血导致的再次剖腹手术位居首位,其次是肺功能不全、外周栓塞和脊柱局部缺血。肾下腹主动脉瘤切除术应在疾病稳定状态下进行,因为多个重要器官系统功能不全可使死亡率增加多达20倍。