腹主动脉瘤合并下肢动脉硬化闭塞的诊治

目的探讨腹主动脉瘤(AAA)合并下肢动脉硬化闭塞的治疗措施。方法回顾性分析我院1991年1月至2010年1月21例AAA合并下肢动脉硬化闭塞患者的临床资料。结果 AAA合并下肢动脉硬化闭塞的发病率随年龄增长,男性多发。1例截肢,5例保守治疗,15例患者接受开放手术或支架治疗,其中7例分别行同期或分期下肢血流重建;3例(14%)死亡,原因均为下肢缺血处理不当,造成下肢坏死、多器官功能衰竭(MOSF)。结论 AAA合并下肢动脉硬化闭塞死亡率高,应引起对该疾病诊断和治疗的重视。

Diagnosis and management of concurrent abdominal aortic aneurysm and limb arterial stenosis

Objective To investigate the management of concurrent abdominal aortic aneurysm （AAA） and limb artery stenosis. Methods The clinical data of 21 hospital patients with concurrent AAA and limb artery stenosis admitted to our hospital, between January 1991 and January 2010 were analyzed retrospectively. Results The incidence of concurrent AAA and limb artery stenosis increased with age. It was more frequent in male than in female. Fifteen patients were operated against AAA with open surgery or endovaseular stent repair. Seven cases underwent limb arterial reconstruction by simultaneous or staged operations. Three cases died from multiple system organ failure （MSOF） with the mortality of 14%, all suffered by inappropriate management of the limbs, whose limbs went necrosis. One patient had amputation. Five patients were medically conservative treated. Conclusion Cautions should be paid to the diagnosis and management of concurrent AAA and limb artery stenosis due to the high mortality.