关键词: 腹主动脉瘤破裂；外科治疗；预后

Abstract:

Objective    To explore  diagnosis, treatment and factors affecting the prognosis of ruptured abdominal aortic aneurysm（RAAA）. Methods    Between March 2003 and February 2009,  clinical data of 19 patients (15 males  4 females ; age range 5082 years, mean age 64.7 years) with RAAA below the level of renal arteries treated with emergency surgery in Shandong Provincial Hospital were analyzed retrospectively. All of the patients were subjected to sudden acuteness bellyache and ensued shock . Among them,  2 cases had a history of AAA and 8 cases had pulsating abdominal masses.  Concomitant diseases included 7  primary hypertension, 3 coronary heart disease and 1 emphysema. All  the patients underwent emergency operation: The ruptures of the abdominal aorta below the level of renal arteries were obstructed by using clamp ring or transluminal balloon according to the conditions of each patient. The artificial vascular graft was taken after the hemorrhage were stopped. After the operation, every patient was followed up for an average of (24±2) months. Results    3 (15.8%) patients died within 30 days after the operation. The causes of death included acute myocardial infarction (1 case) and multiple organ failure (2 cases). Early complications consisted of acute renal failure (4 cases), lung infection (2 cases), and diarrhea (3 cases). During follow-up, no death, anastomotic false aneurysm, graft infection, intravascular thrombus formation or other complications ever occurred. Conclusion    Early diagnosis, emergency surgery to stop bleeding, intensive perioperative management  are the keys to reduce the mortality of RAAA.

Key words: Ruptured abdominal aortic aneurysm; Emergency surgery; Prognosis