肾动脉平面下腹主动脉瘤的外科治疗

目的：探讨肾动脉平面下腹主动脉瘤的外科治疗经验。方法：传统开放手术治疗27例中择期手术19例,动脉瘤破裂行急症手术8例;腔内手术治疗4例。结果：围手术期并发心力衰竭3例,呼吸衰竭8例,急性心肌梗死1例,急性肾功能衰竭4例,术后严重出血1例,死亡5例,余均治愈。结论：外科手术是治疗肾动脉平面下腹主动脉瘤的有效手段,而腔内治疗以其安全、微创、对人体内环境干扰小等优点将成为未来发展的趋势。

Surgical Treatment of Infrarenal Abdominal Aortic Aneurysms

Objective To evaluate our experience of surgical treatment in infrarenal abdominal aortic aneurysms （AAAs）. Methods Clinical data of patients with infrarenal AAA treated by surgical methods were retrospectively reviewed. Results Twenty - seven cases of infrarenal AAA were treated by conventional laparotomic repair. There was 1 death in the 19 cases of elective surgery and there were 4 deaths in the 8 cases with emergency operation because of reptured aneurysms. Four patients with endovascular repair survived after operation. Perioperative complications included heart failure in 3 cases, respiratory failure in g, acute myocardial infarction in l, acute renal failure in 4, and massive hemorrhage after operation in 1. Conclusion The surgical repair is still an effective treatment for infrarenal AAAs and the endovascular repair is the trend of future development due to the advantages of safety, less trauma and less disturbance of internal environment.