感染性腹主动脉瘤的诊疗进展

感染性腹主动脉瘤(IAAA)是由于各种致病菌感染所致的一类特殊类型的动脉瘤。IAAA发病急、病情进展迅速、瘤体易于破裂、临床预后差,因此对其早诊早治十分关键。依据典型病史、实验室检查、CTA影像、术中所见、血培养或组织培养阳性结果可做出诊断。诊断明确后,应在足量应用抗生素的基础上尽早手术治疗。但有关抗生素具体使用方案、手术方案等治疗选择上尚未达成一致。目前推荐术后用抗生素至少6个月以上。伴随微创技术的发展,腔内修复术治疗IAAA的比例越来越高,且短期效果良好,未来有望成为首选的手术方式。

Advances in management of infected abdominal aortic aneurysm

Infected abdominal aortic aneurysm (IAAA) is a special type of aneurysm caused by infection of various pathogenic bacteria. IAAA is characterized by acute onset, rapid progression, high risk of aneurysmal rupture and dismal clinical prognosis. So, early diagnosis and treatment of this condition are extremely critical. Diagnosis can be made based on typical medical history, laboratory tests, CTA images, intraoperative findings, positive results of blood culture or tissue culture. After diagnosis, surgical treatment should be performed as soon as possible on the basis of adequate antibiotic therapy. However, there is no agreement on specific antibiotic treatment options and surgical options so far. It is currently recommended to use antibiotics for at least 6 months after surgery. With the development of minimally invasive techniques, the proportion of IAAA treated by endovascular repair has been increasing with favorable short-term results. Endovascular therapy is expected to be the first choice of options for IAAA in the future.