Ihaya A, Chiba Y, Kimura T, Morioka K, Uesaka T, Muraoka R
Second Department of Surgery, Fukui Medical University Hospital, 23 Shimo-aizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-1193, USA.
Ann Thorac Cardiovasc Surg. 1998 Oct;4(5):247-50.
The risks, results, and postoperative quality of life were evaluated in 11 patients aged 80 years or older who underwent resection of an abdominal aortic aneurysm (AAA). The operative mortality was 9% (1/11). Three patients underwent urgent operation, 1 for impending rupture, 1 for contained rupture, and 1 for rupture into the sigmoid colon. Preoperative risk factors such as hypertension, electrocardiographic abnormalities, and respiratory dysfunction were found in about half of the patients. Neither operative mortality nor long-term survival were influenced by the preoperative risk factors. The quality of life enjoyed by these patients was not adversely affected by AAA resection. Surgical treatment of AAA should be undertaken in selected octogenarians to prevent rupture. Physiologic status rather than chronologic age should determine which patients undergo aneurysm resection.
对11例80岁及以上接受腹主动脉瘤(AAA)切除术的患者的风险、结果及术后生活质量进行了评估。手术死亡率为9%(1/11)。3例患者接受了急诊手术,1例因动脉瘤即将破裂,1例因局限性破裂,1例因破裂至乙状结肠。约半数患者存在高血压、心电图异常及呼吸功能障碍等术前危险因素。术前危险因素对手术死亡率及长期生存率均无影响。这些患者的生活质量并未因AAA切除术而受到不利影响。对于选定的八旬老人应进行AAA手术治疗以预防破裂。应根据生理状态而非实际年龄来决定哪些患者接受动脉瘤切除术。