胸腹主动脉瘤手术后并发症及死亡原因分析

目的探讨胸腹主动脉瘤(thoraco—abdominal aortic aneurysm，TAA)患者手术后并发症和死亡与术前、术中各高危因素问的相互关系并寻求影响其发生的独立决定因素。方法选择1993年1月至2001年12月行手术治疗的TAA患者23例，统计手术后并发症率和死亡率，分析术前心、肺、肝、肾功能和术中主动脉阻断位置、时间以及急诊手术等因素与术后并发症、死亡发生的关系。结果手术后并发症率87．0％，死亡率30．4％。并发症以肾、肝、肺系统损害及截瘫的发生率最高；死亡原因以急性肾衰发生最多。结论术中主动脉阻断时间、术中和术后24h内输血量是影响手术后并发症和死亡发生的独立决定因素。

Perioperative morbidity and mortality of the thoraco-abdominal aortic aneurysm:an analysis of 23 cases

Objective To study the perioperative morbidity and mortality of thoraco-abdominal aortic aneurysm ( TAA ) and analyze the relationship between the preoperative or intraoperative risk factors and the morbidity or mortality. MethodsTwenty-three TAA cases undergoing surgery between Jan. 1993 and Dec. 2001 were enrolled. Preoperative cardial, pulmonary, hepatic and renal function, the site and period of intraoperative aortic clamping as well as the emergency operation were taken into account to evaluate independent determinants of the perioperative morbidity and mortality. ResultsThe perioperative morbidity and mortality were 87.0% and 30.4% respectively. As to the morbidity, pulmonary, hepatorenal dysfunction and paraplegia are commonly seen in perioperative period of TAA. Acute renal failure is the most important cause of perioperative death. ConclusionsIntraoperative aortic blocking and massive blood transfusion are the independent determinants influencing perioperative adverse events significantly.