Hiatt J C, Barker W F, Machleder H I, Baker J D, Busuttil R W, Moore W S
Arch Surg. 1984 Nov;119(11):1264-8. doi: 10.1001/archsurg.1984.01390230036008.
One must identify those fatal errors in the treatment of patients with ruptured abdominal aortic aneurysms (AAAs) to improve future treatment and reduce mortality. Our vascular registry identified 29 patients with ruptured AAAs who died following admission to the UCLA Hospital, Los Angeles, and the Sepulveda (Calif) Veterans Administration Hospital between 1971 and 1981. Review of the records identified four categories of error that contributed to death. These included failure to proceed with elective aneurysmectomy in 12 patients with known AAAs, error in the diagnosis of aortic rupture that led to delay in getting nine patients to the operating room, intraoperative technical error that produced venous injury in eight patients, and undue delay in anesthetic induction in four patients. Following the outline of a careful treatment approach should further reduce the mortality in the treatment of patients with ruptured AAAs.
必须找出腹主动脉瘤（AAA）破裂患者治疗中的那些致命错误，以改进未来的治疗并降低死亡率。我们的血管登记处识别出1971年至1981年间在洛杉矶加州大学洛杉矶分校医院和（加利福尼亚州）塞普尔韦达退伍军人管理局医院住院后死亡的29例AAA破裂患者。对病历的审查确定了导致死亡的四类错误。其中包括12例已知AAA患者未进行择期动脉瘤切除术，9例患者因主动脉破裂诊断错误导致延误送手术室，8例患者术中技术错误导致静脉损伤，以及4例患者麻醉诱导过度延迟。遵循谨慎治疗方法的概要应能进一步降低AAA破裂患者治疗中的死亡率。
