摘要
目的探讨肾下腹主动脉重建在腹主动脉瘤 (abdominalaorticaneurysm ,AAA)和主髂动脉闭塞症 (aortoiliacocclusivedisease ,AIOD)中的手术风险 ,分析造成差异的可能原因。方法回顾性总结 340例 (2 2 2例腹主动脉瘤和 118例主髂动脉闭塞症 )肾下腹主动脉重建手术的临床资料。结果手术总死亡率为 7 6 % ,其中主髂动脉闭塞症手术死亡率为 11 9% ,明显高于腹主动脉瘤的5 4 % (χ2 =4 5 5 1,P <0 0 5 )。手术总并发症发生率为 2 2 4 % ,其中主髂动脉闭塞症为 2 8 8% ,明显高于腹主动脉瘤的 18 9% (χ2 =4 346 ,P <0 0 5 )。多脏器功能衰竭为两组中主要的死亡原因 ,呼吸系统感染为最主要的术后并发症。危险因素中 ,男女性别比、吸烟状况、糖尿病 3个因素在AOID组明显高于AAA组 (P均 <0 0 1) ,高血压、心电图ST段改变、肺功能不全等AIOD组也高于AAA组 ,但差异无显著意义。年龄构成、肾功能不全和手术时间等两组无统计学差异 ,输血量AAA组明显高于AIOD组。结论主髂动脉闭塞症手术风险高于腹主动脉瘤 ,吸烟、糖尿病、重要脏器功能状况是造成手术风险差异的主要原因。
Objective To compare operative risks of the infrarenal aortic artery reconstruction between abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD), and to analyze the causes of the difference. Method Clinical data of 340 cases undergoing aortic artery reconstructions including 222 AAA cases and 118 AIOD cases , were analyzed retrospectively. Results The perioperative mortality was 7.6% and the mortality in AAA group (5.4%) was lower than that in AIOD group (11.9%)(P<0.05). There were less complications in AAA group (18.9%) than in AIOD group (28.8%)(P<0.05). There was no significant difference between the two groups with regard to the cause of death. Multiple system organ failure was the leading cause of death in both groups. Pulmonary complication was more often seen after infrarenal aortic artery reconstruction. The male population preponderance, smoking and diabetes were the risk factors in AIOD group which may be responsible for higher mortality and morbidity. The average blood transfusion was larger in AAA group than that in AIOD group. Conclusions The operative risk of the aortic artery reconstruction is higher in patients with AIOD. Risk factors such as smoking, diabetes and the condition of life organs may be the causes of the difference in mortality and morbidity in the two groups.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第11期654-656,共3页
Chinese Journal of General Surgery
关键词
肾下腹主动脉重建术
治疗
腹主动脉瘤
主髂动脉闭塞症
风险比较
Aortic aneurysm, abdominal
Arterial occlusive diseases
Vascular surgical procedures
Postoperative complications
