Björck M, Troëng T, Bergqvist D
Department of Surgery, Skellefteå District Hospital, Sweden.
Eur J Vasc Endovasc Surg. 1997 Jun;13(6):531-9. doi: 10.1016/s1078-5884(97)80061-5.
To identify risk factors for intestinal ischaemia after aortoiliac surgery.
Among 2824 patients operated on during 1987-93 and registered prospectively in the Swedish Vascular Registry, 62 cases of postoperative intestinal ischaemia were identified. They were compared with the remaining 2762 patients through the registry and with a random sample of 127 controls through patient records. Multivariate analysis was performed.
Patients in shock operated on for ruptured aneurysms were at greatest risk of developing postoperative intestinal ischaemia. Excluding patients in shock, operation for aneurysmal disease and for occlusive disease carried the same risk. Renal disease, emergency surgery, age, type of hospital, aortobifemoral graft, operating time, cross-clamping time and ligation of one or both internal iliac arteries were independent risk factors.
Patient-related haemodynamic risk factors together with surgical skill and decision making defines the risk for this serious complication.
确定主髂动脉手术后肠道缺血的危险因素。
在1987年至1993年期间接受手术并前瞻性登记在瑞典血管登记处的2824例患者中，确定了62例术后肠道缺血病例。通过登记处将他们与其余2762例患者进行比较，并通过患者记录与127例对照的随机样本进行比较。进行多变量分析。
因动脉瘤破裂而接受手术的休克患者发生术后肠道缺血的风险最高。排除休克患者后，动脉瘤疾病手术和闭塞性疾病手术的风险相同。肾病、急诊手术、年龄、医院类型、主动脉双股移植、手术时间、交叉钳夹时间以及一侧或双侧髂内动脉结扎是独立的危险因素。
与患者相关的血流动力学危险因素以及手术技巧和决策决定了这种严重并发症的风险。
