Bradbury A W, Makhdoomi K R, Adam D J, Murie J A, Jenkins A M, Ruckley C V
University Department of Surgery, Edinburgh Royal Infirmary, UK.
Br J Surg. 1997 Dec;84(12):1705-7.
The operative mortality rate for elective repair of asymptomatic abdominal aortic aneurysm (AAA) is falling but the fate of patients with ruptured AAA may have changed little over the past decade.
This study was an analysis of a prospectively gathered computerized database.
In the 12 years to 31 December 1994, 1144 patients underwent (attempted) repair of AAA. In 514 patients (44.9 per cent) who had an operation for ruptured AAA there was no significant change in the mean age, male:female ratio (418:96), or operative mortality rate (35.0 per cent) over the interval of the study. Forty-seven patients died before reaching the operating theatre, giving an 'intention to operate' mortality rate of 40.5 per cent. A further 68 patients (10.8 per cent of all patients who presented with a ruptured AAA) were not offered operation because of poor medical condition (n = 34) or extreme age (n = 34); three patients refused operation. A greater proportion of patients had surgery between 1989 and 1994 (276 of 323, 85.4 per cent) than between 1983 and 1988 (238 of 309, 77.0 per cent) (P < 0.01, chi2 test).
The proportion of aneurysms operated on for rupture in this unit remains high (almost 50 per cent). The results of surgery for ruptured AAA have not improved in the past 12 years.
无症状腹主动脉瘤（AAA）择期修复的手术死亡率正在下降，但在过去十年中，破裂性AAA患者的预后可能变化不大。
本研究是对前瞻性收集的计算机化数据库的分析。
截至1994年12月31日的12年中，1144例患者接受了（尝试）AAA修复。在514例因破裂性AAA接受手术的患者中，在研究期间，平均年龄、男女比例（418:96）或手术死亡率（35.0%）均无显著变化。47例患者在到达手术室前死亡，“拟手术”死亡率为40.5%。另有68例患者（占所有破裂性AAA患者的10.8%）因病情不佳（n = 34）或年龄过大（n = 34）未接受手术；3例患者拒绝手术。1989年至1994年期间接受手术的患者比例（323例中的276例，85.4%）高于1983年至1988年期间（309例中的238例，77.0%）（P < 0.01，卡方检验）。
该单位因破裂而接受手术的动脉瘤比例仍然很高（近50%）。在过去12年中，破裂性AAA的手术结果没有改善。
