Miani S, Mingazzini P, Piglionica R, Biasi G M, Ruberti U
J Cardiovasc Surg (Torino). 1984 Sep-Oct;25(5):414-9.
This study presents an analysis of the influence of the site of rupture of abdominal aortic aneurysms on the postoperative survival rate. A series of 226 patients, who underwent emergency operations for ruptured aneurysms, is examined. The three most important methods of rupture are: (1) Retroperitoneal rupture: this type is associated with a very high mortality (52.8% in our experience), which reaches almost 75% when the posterior parietal peritoneum tears and massive intraperitoneal bleeding occurs. This mortality is related to the amount of blood loss, hypovolemic shock, the number of transfused blood units and, especially, to increasing renal insufficiency. (2) Rupture into the inferior vena cava: in this event the mortality rate it less severe (38.4% in our experience) and it is mostly related to the occurrence of an high output cardiac failure, as well as to oliguria or anuria following renal venous hypertension. (3) Enteric rupture: this is, in our experience, the most uncommon event. It carries a high mortality rate (50%). The copious bleeding, which is unrestricted in hollow organs, explains the dangerous hypovolemic shock, while massive blood reabsorption from the enteric tract leads to a renal insufficiency.
本研究分析了腹主动脉瘤破裂部位对术后生存率的影响。对226例因动脉瘤破裂接受急诊手术的患者进行了检查。三种最重要的破裂方式为：（1）腹膜后破裂：这种类型的死亡率非常高（根据我们的经验为52.8%），当后腹膜壁层撕裂并发生大量腹腔内出血时，死亡率几乎达到75%。这种死亡率与失血量、低血容量性休克、输血量有关，尤其与肾功能不全的加重有关。（2）破入下腔静脉：这种情况下死亡率较低（根据我们的经验为38.4%），主要与高输出量心力衰竭的发生以及肾静脉高压后的少尿或无尿有关。（3）肠破裂：根据我们的经验，这是最不常见的情况。其死亡率很高（50%）。中空器官内不受限制的大量出血导致危险的低血容量性休克，而肠道大量血液吸收导致肾功能不全。
