Gétaz E P, Louw J H
Postgrad Med J. 1977 Nov;53(625):668-71. doi: 10.1136/pgmj.53.625.668.
The authors in this article record their experience with eight-four patients with abdominal aortic aneurysms. Twenty-seven patients (32%) presented with ruptured aneurysms with an overall mortality of 56%. Of the unruptured aneurysms, 67% were operable with a mortality of 5.3%. The highest mortality amongst the patients with ruptured aneurysms was in the group who was shocked. In the group with ruptured aneurysms, of those in whom platelet counts were performed, 50% were abnormally low, and 56% had evidence of abnormal coagulation. Seventy per cent of those with coagulation abnormalities died. In the unruptured group 28.2% had thrombocytopenia but no other abnormalities of coagulation. All patients undergoint aneurysm resection should have a platelet count and a full clotting screen. Therapy should be directed to normalization of the coagulation system.
本文作者记录了他们对84例腹主动脉瘤患者的治疗经验。27例(32%)患者为动脉瘤破裂,总体死亡率为56%。在未破裂的动脉瘤中,67%适合手术,死亡率为5.3%。破裂动脉瘤患者中死亡率最高的是休克组。在破裂动脉瘤组中,进行血小板计数的患者中,50%血小板计数异常低,56%有凝血异常证据。有凝血异常的患者中70%死亡。在未破裂组中,28.2%有血小板减少症,但无其他凝血异常。所有接受动脉瘤切除术的患者都应进行血小板计数和全面的凝血筛查。治疗应致力于使凝血系统恢复正常。