科研之友
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摘要
Background: This study aims to report the results of emergency operations of ruptured abdominal aortic aneurysm. Methods: Between February 2001 and February 2011, 20 patients (1 female, 19 males; mean age 64.9 +/- 9.4 years; range 50 to 77 years) who were admitted to the emergency department and underwent emergency operation for ruptured abdominal aort aneurysm were retrospectively analyzed. Combined left thoracotomy + median laparotomy was performed in one patient (5%), while median laparotomy alone was performed in others. Aaortic cross clamping was applied following heparinization. In patients in whom aortic cross clamping was not suitable (n=3), proximal bleeding control was performed through occlusion by endoclamping with a Foley catheter. Aneurysmectomy + aortobifemoral bypass was performed in six patients (30%), aneurysmectomy + aortobiiliac bypass in 10 (50%), aneursymectomy + abdominal aortic graft interposition in two (10%), explorative laparotomy in one (5%), and thoracic + abdominal exploration in one (5%). Polytetrafluoroethylene (PTFE) pant graft (80%) and Dacron tube graft (10%) were used as graft materials during surgery. Results: In the early postoperative period, ischemic colitis developed in one patient (5%), prolonged entubation (>72 hours) in four (20%), wound infection in one (5%), arrhythmia in two (10%), and disseminated intravascular coagulation in one (%5). The mean duration of intensive care unit and hospital stay were 3.8 +/- 2.1 days and 8.5 +/- 3.4 days, respectively. Total mortality was seen in four patients (20%). Conclusion: We believe that early diagnosis of a ruptured abdominal aort aneurysm and endoclamping with a Foley catheter or an intraaortic balloon occlusion in patients who are ineligible for aortic cross clamping may increase the success of an emergency operation.
- 出版日期2014-7
