Sandison A J, Panayiotopoulos Y, Edmondson R C, Tyrrell M R, Taylor P R
Department of Surgery, Guy's Hospital London, UK.
Br J Surg. 1996 Oct;83(10):1386-9. doi: 10.1002/bjs.1800831019.
This study was a 4-year prospective audit of abdominal aortic aneurysm surgery including 222 aneurysm repairs: 106 elective, 76 urgent and 40 emergency. Twenty-five patients died: four who underwent elective surgery, seven urgent and 14 emergency. The two major causes of death, multiple organ failure and colonic ischaemia, were responsible for 11 of the 25 deaths. The three deaths from myocardial infarction all occurred in patients with a leaking aneurysm. Blood loss was significantly higher in patients with multiple organ failure and in those with colonic ischaemia. Methods to identify patients at high risk of massive blood loss and colonic ischaemia may be a way to reduce mortality.
本研究是一项对腹主动脉瘤手术进行的为期4年的前瞻性审计，包括222例动脉瘤修复手术：106例择期手术、76例急诊手术和40例紧急手术。25例患者死亡：4例接受择期手术，7例急诊手术，14例紧急手术。死亡的两大主要原因是多器官功能衰竭和结肠缺血，25例死亡中有11例由此导致。3例心肌梗死死亡均发生在动脉瘤破裂患者中。多器官功能衰竭患者和结肠缺血患者的失血量明显更高。识别大出血和结肠缺血高危患者的方法可能是降低死亡率的一种途径。
