Zarnke M D, Gould H R, Goldman M H
University of Tennessee Medical Center at Knoxville, Department of Surgery 37920.
Surgery. 1988 Jun;103(6):638-42.
Computed tomography was used to evaluate 25 hemodynamically stable patients with suspected leaking abdominal aortic aneurysms. Of 10 patients found to have the presence of free retroperitoneal blood, six underwent immediate operation and five survived (83%). Delay in operation uniformly resulted in death. There was one false-positive study. Twelve patients demonstrated no extravascular fluid on initial computed tomography interpretation. Unsuspected nonvascular problems were found in six patients (40%). There was one false-negative study that resulted in a death. Clinical findings at initial examinations were similar in both groups. We conclude that in the hemodynamically stable patient, combining prompt computed tomography evaluation and immediate operation optimizes outcome in patients with leaking abdominal aortic aneurysms.
计算机断层扫描用于评估25例血流动力学稳定但疑似腹主动脉瘤破裂的患者。在10例发现有腹膜后游离血液的患者中，6例接受了急诊手术，5例存活（83%）。手术延迟均导致死亡。有1例假阳性检查结果。12例患者在最初的计算机断层扫描解读中未显示血管外积液。6例患者（40%）发现了未被怀疑的非血管性问题。有1例假阴性检查结果导致了1例死亡。两组患者初次检查时的临床表现相似。我们得出结论，对于血流动力学稳定的患者，及时进行计算机断层扫描评估并立即手术可优化腹主动脉瘤破裂患者的治疗结果。
