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肾下腹主动脉瘤。附115例报告

[Aneurysms of the subrenal abdominal aorta. Apropos of 115 cases].

作者信息

Maillard P, Ribal J P, Glanddier G

出版信息

J Mal Vasc. 1985;10(4):297-302.

PMID:4093717
Abstract

115 of infra renal abdominal aorta have been operated upon between 1969 and 1984. 107 male patients (93%) and 8 female (7%) were treated. Age was 65.5. Associated high blood pressure was found in 43%, smoking in 74% and coronary disease in 20.5%. Non ruptured aneurysms were 84 (73%) and diagnosis was made chiefly in ischemia of lower limbs, ruptured were 31 (27%). 4 fistulas between aorta and lower vena cava were found at surgery. Aortograms have not been done in every case, even for non ruptured aneurysms, as 19 patients have been operated without (22.6% of non ruptured aneurysms). Ultrasonography have been done in 37. Among 84 patients with non ruptured aneurysm, 6 were not operated, 2 got only palliative surgery for rest pain, and 76 (85.7%) underwent resection and grafting. 31 patients were operated when ruptured. Post operative mortality for non ruptured aneurysms was of 2 (2.63%) for resection and grafting. It was of 24 (77.4%) if ruptured. Follow-up study shows that at a five years range 62.7% of surviving operated patients are alive. Authors point out that lower limbs ischemia is still often a revealing symptom. Post operative colic ischemia is rare.

摘要

1969年至1984年间,对115例肾下腹主动脉进行了手术治疗。治疗了107例男性患者(93%)和8例女性患者(7%)。年龄为65.5岁。发现43%的患者伴有高血压,74%的患者吸烟,20.5%的患者患有冠心病。未破裂动脉瘤84例(73%),主要诊断依据为下肢缺血;破裂动脉瘤31例(27%)。手术中发现4例主动脉与下腔静脉瘘。并非对每例患者都进行了主动脉造影,即使是未破裂动脉瘤患者,因为有19例患者未进行造影就接受了手术(占未破裂动脉瘤患者的22.6%)。37例患者进行了超声检查。在84例未破裂动脉瘤患者中,6例未接受手术,2例仅因静息痛接受了姑息性手术,76例(85.7%)接受了切除和移植手术。31例患者在动脉瘤破裂时接受了手术。未破裂动脉瘤切除和移植术后死亡率为2例(2.63%)。破裂时死亡率为24例(77.4%)。随访研究表明,在五年范围内,存活的手术患者中有62.7%仍存活。作者指出,下肢缺血仍然常常是一个提示症状。术后结肠缺血很少见。

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