腹腔内脏动脉瘤的外科治疗——附46例分析

目的探讨腹腔内脏动脉瘤(VAAs)的合理治疗策略。方法回顾性分析我院2000～2012年间随访资料完整的46例VAAs病例的临床资料及其治疗效果。结果 46例患者中男性21例,女性25例,其中肾动脉瘤10例,肠系膜上动脉瘤8例,肝动脉瘤7例,脾动脉瘤16例,胃十二指肠上动脉瘤2例,多发性VAA3例。37例接受介入治疗,9例接受开放手术,一次手术技术成功率为95.9%,二次手术技术成功率为100%。术后1例并发肠瘘、腹腔感染和肾功能损害,经治疗后康复出院。随访5～120(平均47.5)个月,除1例大动脉炎患者因再发肾动脉瘤破裂死亡外其余患者均存活。结论介入治疗及开放手术相结合是治疗VAA的合理手段,应根据患者的具体情况选择相应的治疗方式。

Treatment for visceral artery aneurysms:an analysis of 46 cases

Objective To investigate the rational surgical strategy for visceral artery aneurysms (VAAs). Methods The clinical data of 46 patients with VAAs treated in our department from Jan. 2000 to Jun. 2012 were analyzed retrospectively. Results Of 46 cases, 21 men and 25 women with VAAs were recruited. VAAs involved 12 renal arteries, 8 superior mesenteric arteries, 7 hepatic arteries, 19 splenic arteries and 3 gastroduodenal arteries. Endovascular intervention was carried out on 37 patients while surgical treatment was performed on 9 patients. The technical success rate of the first and the second intervention was 95.9% and 100%, respectively. Despite 1 patient suffered from intestinal fistula, abdominal infection and renal dysfunction and recovered and discharged after treatment, all other patients recovered uneventfully. During the follow-up time of 5 to 120 (mean 47.5) months, 45 patients survived while 1 patient died from rupture of a newly emerged left renal artery aneurysm. Conclusion Patient-specifically designed interventional therapy or surgical treatment may be the optimal treatment for visceral artery aneurysms.