Leong Y P, Sappany A
Tawakal Medical Centre, Jalan Pahang, Kuala, Lumpur.
Med J Malaysia. 1995 Dec;50(4):330-3.
The management of abdominal aortic aneurysms (AAA) at a private medical centre was reviewed. The criteria for surgery were AAA more than or equal to five centimeters in diameter, symptomatic AAA even if less than five centimeters and ruptured AAA. A total of 67 patients were seen between October 1991 to September 1994. The age range was 48 to 94 years, mean = 69.8. There were 58 males to nine females. Twelve patients presented with ruptured AAA. There were three suprarenal AAA and three mycotic AAA. Aneurysmectomies were performed on 50 patients. This include all patients with ruptured AAA. There was no mortality in the elective cases. One patient with ruptured AAA died, ie. an operative mortality of eight per cent. It was concluded that a very low operative mortality can be achieved in this group of high risk patients. Our results were comparable to those reported by other centres in the developed countries. Important factors contributing to these results include a team approach in a unit interested in this disease, careful pre-operative preparation and a rigid post-operative regime. For ruptured AAA, survival of the patient depended on a successful and timely operation. It was also concluded that no patient should be deemed unfit for surgery or denied an operation if they needed to have one and it was safe to transport patients with ruptured AAA to a centre where the operation can be performed.
对一家私立医疗中心腹主动脉瘤（AAA）的治疗情况进行了回顾。手术标准为直径大于或等于5厘米的AAA、有症状的AAA（即使直径小于5厘米）以及破裂的AAA。1991年10月至1994年9月期间共诊治了67例患者。年龄范围为48岁至94岁，平均年龄为69.8岁。男性58例，女性9例。12例患者为破裂性AAA。有3例肾上腹主动脉瘤和3例霉菌性腹主动脉瘤。对50例患者进行了动脉瘤切除术。这包括所有破裂性AAA患者。择期手术病例无死亡。1例破裂性AAA患者死亡，即手术死亡率为8%。得出的结论是，在这组高危患者中可以实现非常低的手术死亡率。我们的结果与发达国家其他中心报告的结果相当。促成这些结果的重要因素包括在一个对该疾病感兴趣的科室采用团队治疗方法、仔细的术前准备和严格的术后管理方案。对于破裂性AAA，患者的存活取决于成功及时的手术。还得出结论，如果患者需要手术且将破裂性AAA患者转运到能够进行手术的中心是安全的，那么不应认为任何患者不适合手术或拒绝为其进行手术。
