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COMPARISON OF ENDOVASCULAR REPAIR AND OPEN REPAIR FOR RUPTURED ABDOMINAL AORTIC ANEURYSM

Objective To compare the effectiveness between conventional open repair (OR) and endovascular repair (EVRAR) for ruptured abdominal aortic aneurysm. Methods Between March 2000 and July 2011, 48 cases of ruptured abdominal aortic aneurysm were treated by conventional OR in 40 cases (OR group) or by EVRAR in 8 cases (EVRAR group). There was no significant difference in age, sex, the neck length (less than 2 cm), the neck angulation of aneurysm (more than60°), il iac severe tortuosity, preoperative systol ic pressure, and preoperative comorbidity between 2 groups (P gt; 0.05). The blood transfusion volume, operation time, intensive care unit (ICU) stay, postoperative complications, reinterventions, and mortality were analyzed. Results There was no significant difference in 24-hour and 30-day mortality rates and non graft-related complications between 2 groups (P gt; 0.05). EVRAR group was significantly better than OR group in blood transfusion volume, operation time, and ICU stay (P lt; 0.05), but OR group was significantly better than EVRAR group in reinterventions and graftrelated complications (P lt; 0.05). Conclusion EVRAR has obvious advantages in blood transfusion volume, operation time, and ICU stay, so it is feasible for ruptured abdominal aortic aneurysm in patients with precise anatomical suitability.

Clinical Analysis of Ruptured Abdominal Aortic Aneurysm (Report of 6 Cases)

目的　探讨腹主动脉瘤破裂的诊断和治疗方法。方法　我院从1999年10月至2004年1月期间经手术治疗腹主动脉瘤破裂6例。结果　1例患者因术后失血性休克而死亡； 5例患者随访4年，1例术后2年死于心肌梗死，余4例存活。结论　腹主动脉瘤应早期诊断、早期治疗，一旦破裂应迅速诊断、急诊手术，手术时应注意阻断腹主动脉的方法以及防止术后下肢缺血。

主动脉窦动脉瘤破裂合并妊娠前置胎盘的围手术期护理一例

颅内后交通动脉瘤夹闭术中动脉瘤破裂出血的处理分析

目的 探讨颅内后交通动脉瘤夹闭术中动脉瘤破裂出血的预防及处理。 方法 收集 2010 年 6 月—2015 年 6 月收治的 40 例采用开颅显微镜下动脉瘤夹闭术治疗颅内后交通动脉瘤患者的临床资料并进行分析。 结果 40 例患者中，14 例发生动脉瘤夹闭术中动脉瘤破裂，发生率为35%。发生动脉瘤破裂出血的部位分别为：动脉瘤颈 2 例，动脉瘤体 4 例，动脉瘤顶 8 例。14 例发生动脉瘤夹闭术中动脉瘤破裂的患者经过相应处理后均成功夹闭。术后随访 6 个月，采用格拉斯哥预后评分进行评价，恢复良好 4 例，轻度残疾 3 例，重度残疾 4 例，植物生存 2 例，死亡 1 例。 结论 开颅夹闭后交通动脉瘤时不仅要妥善处置好瘤体，还要做好预防夹闭动脉瘤破裂出血的准备，细心操作及综合处置，才能减少术中出血、利于患者良好恢复。

Advances in surgical indications and morphological rupture-risk assessment of abdominal aortic aneurysms

ObjectiveThis paper aimed to summarize the new progress in surgical indications regarding as maximum diameter from evidence-based medical evidence and morphological rupture-risk assessment of abdominal aortic aneurysms (AAA) and its clinical application value.MethodThe rupture-risk and its mechanism of AAA in specific population and morphological characteristics were reviewed.ResultsAsymptomatic patients in specific subgroups may also benefit from AAA repair by lowering the intervention threshold. Besides the maximum diameter of aneurysm, other morphological factors, such as the true geometric shape, the wall thickness, and mural thrombus also had important predictive value for AAA rupture risk.ConclusionRupture-risk assessment based on the actual individual situation of AAA patients can further facilitate the clinical diagnosis and treatment.