腹主动脉瘤的外科诊疗

目的：总结腹主动脉瘤的诊断和外科治疗方法.方法：回顾性分析2003-01～2005-04我院治疗的23例肾下型腹主动脉瘤的临床资料.男21例,女2例,年龄54～76岁.均为肾动脉下型腹主动脉瘤,瘤体直径4.0～7.5 cm.采取常规的腹主动脉瘤切除和原位人造血管移植术20例,腔内人造血管移植术3例.结果：全组无术后早期死亡,无严重出血、肾功能衰竭和下肢动脉栓塞等,术后并发心律失常2例,腹泻2例,切口裂开1例.全组患者随访1～27个月,无晚期死亡和肾功能衰竭.结论：常规外科手术和腔内人造血管移植治疗腹主动脉瘤均获得良好效果.早诊断、合理选择手术时机和手术方式是提高手术成功率、减少术后并发症和死亡率的关键.

Diagnosis and surgical treatment of abdominal aortic aneurysms in 23 cases

Objective: To summarize the experience of diagnosis and surgical treatment of infrarenal abdominal(aortic) aneurysms(AAA) in 23 patients.Methods: Details of 23 cases operated upon for infrarenal abdominal(aortic) aneurysm from Jan.2003 to Apr. 2005 were analyzed retrospectively.There were twenty-one males and two females.The age ranged from 54 to 76 years.The operative procedure included conventional open repair and(endoluminal) repair.Results:There was no early operative deaths.The major complications included 2 patients with arrhythmia,2 with diarrhea,one with disruption of wound.There was no exceeding postoperative bleeding,low(extremites) embolism and renal failure. All patients were followed up for 1 to 27 months.There was no late death and no recurrence of aortic aneurysms.Conclusion:Open repair and endoluminal repair of infrarenal AAA are two effective techniques with excellent clinical outcomes.Early diagnosis,proper surgical timing and(technique),(perioperative) intensive care play the key roles in repairing AAA.