Mackiewicz Z, Molski S, Szpinda M, Jundzill W, Stankiewicz W
Department of General and Vascular Surgery, Ludwik Rydygier Medical University, Bydgoszcz, Poland.
J Mal Vasc. 1998 Dec;23(5):368-70.
About 40% of patients with ruptured abdominal aortic aneurysm (AAA) die before admission to the hospital. The next 40-50% of patients who reach a hospital die in the perioperative period or within 30 days after surgery. Two groups of patients with ruptured AAA can be distinguished: first-with intra-abdominal rupture, second-with retro-peritoneal rupture. The aim of the study was a retrospective analysis of the treatment results in patients with retro-peritoneal rupture of AAA.
78 patients underwent a surgical procedure between 1.01.1985 and 30.10.1996. 78 patients (68 men and 10 women), mean age 67.6 (53-94) were included in this study. Based on diagnostic and surgical procedures, two periods of treatment can be distinguished. In the first period of the time from 1.01.1985 to 31.12.1992 patients were operated on immediately after admission to the hospital. In the second period from 1.01.1993 to 31.10.1996 patients were admitted to Intensive Care Unit. In this unit patients were intensively treated and prepared for surgical procedure. During this time the computerized tomography scanning (CT) was performed.
In the first period the perioperative mortality was 75%. In the second period the perioperative mortality was 41.3%.
The 1.5-2 hours postponement of operative procedure of the patients with retro-peritoneal rupture of AAA can decrease perioperative mortality. During the time patients were intensively treated and prepared for surgical procedure and CT examination enabled to choose proper surgical technique.
约40%的腹主动脉瘤（AAA）破裂患者在入院前死亡。接下来40%-50%到达医院的患者在围手术期或术后30天内死亡。可将两组AAA破裂患者区分开来：第一组为腹内破裂，第二组为腹膜后破裂。本研究的目的是对AAA腹膜后破裂患者的治疗结果进行回顾性分析。
1985年1月1日至1996年10月30日期间，78例患者接受了外科手术。本研究纳入了78例患者（68例男性和10例女性），平均年龄67.6岁（53-94岁）。根据诊断和外科手术程序，可区分两个治疗阶段。在第一阶段，即1985年1月1日至1992年12月31日，患者入院后立即接受手术。在第二阶段，即1993年1月1日至1996年10月31日，患者被收入重症监护病房。在该病房对患者进行强化治疗并为外科手术做准备。在此期间进行了计算机断层扫描（CT）。
第一阶段围手术期死亡率为75%。第二阶段围手术期死亡率为41.3%。
AAA腹膜后破裂患者手术推迟1.5-2小时可降低围手术期死亡率。在此期间，对患者进行强化治疗并为外科手术做准备，CT检查有助于选择合适的手术技术。
