腹主动脉瘤手术并发结肠缺血的临床分析

目的：探讨腹主动脉瘤（abdominal aortic aneurysm,AAA)手术并发结肠缺血的病因和防治措施。方法：对140例AAA手术并发经肠缺血的7例患者进行回顾性分析。结果：3例患者为AAA破裂急诊手术,7例患者均行AAA切除,人工血管置换术及肠系膜下动脉（inferior mesenteric artery,IMA)结扎术,有2例患者同时结扎双侧髂内动脉（internal iliac artery,IIA),2例患者同时结扎一侧IIA,3例患者行肠切除术,1例患者行IMA重,3例患者行保守疗法,术后3例患者因多器官功能衰竭死亡。结论：正确防治结肠缺血和坏死可有效降低AAA 手术病死率,有利于术后的康复。

Clinical analysis of colon ischemia complicating with operated abdominal aortic aneurysm

Objective To investigate the etiology, prevention and treatment of colon ischemia after operation for abdominal aortic aneurysm (AAA). Method Seven of 140 cases complicated with colon ischemia who had received AAA operation were analyzed retrospectively. Results Three cases underwent emergency operation. The seven cases were subjected to removal of AAA, implantation of prosthesis, and ligation of the inferior mesenteric artery. Two cases had the ligation of the bilateral internal iliac artery (IIA). Epiliateral IIA was ligated in 2 cases. Bowel resection was carried out in 3 cases, 1 of which received reconstruction of the inferior mesenteric artery (IMA). Three cases received conservative therapy, but died from multiply organ failure. Conclusion Correct prevention and management of colon ischemia can effectively reduce the operative morbidity of AAA patients.