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1、破裂性骼动脉瘤的救治体会李海辉1赵亮1谢锐1任为2(通讯作者)(1重庆医科大学重庆400016)(2重庆医科大学附属第一医院血管外科重庆400016)【摘要】目的:总结10例破裂骼动脉瘤的诊治经验。方法:对2011年1月〜2015年10月我院10例破裂骼动脉瘤患者的临床资料进行回顾性分析。结果腔内治疗7例,开腹手术治疗1例,2例患者放弃手术。8例手术患者手术均获得成功(术前症状均消失),围术期无死亡病例,围术期二次介入治疗1例,1例放弃手术患者发病72h内死于失血性循环衰渴。随访3月〜3年,8例患者获得随访,失访1例(为放弃手术患者),死亡2例(均为腔内治疗患者,
2、死因均与动脉瘤无关),臀肌跛行或下肢肿痛3例,无任何不适症状3例。结论腔内治疗和开腹手术均是破裂骼动脉瘤的有效治疗方法,对于可耐受手术治疗的破裂骼动脉瘤患者建议积极行手术治疗。腔内治疗近期并发症较多,远期并发症有待进一步随访。【关键词】骼动脉瘤;破裂;并发症;死亡;治疗【中图分类号】R732.2【文献标识码】A【文章编号】1007-8231(2015)22-0125-03TheManagementOfRupturedIliacArteryAneurysmLiHaihuil,ZhaoLiangl,XieRuil,RenWei,Correspondingauthor,
3、2(1.Chongqingmedicaluniversity,Chongqing400016,China;2.DepartmentofVascularSurgery,ThefirstaffiliatedhospitalofChongqingmedicaluniversity,Chongqing400016,China【Abstract[ObjectiveTosummarizetheexperienceoftreatmentofrupturediliacarteryaneurysmin10cases.MethodsThedataof10caseswithruptur
4、ediliacarteryaneurysm(RIAA)inourdepartmentfromJanuary2011toDecember2015wereretrospectivelyanalyzed.ResultsEndovasculartreatmentwasperformedin7cases,opensurgeryin1case,and2patientsgaveupsurgery.Allthe8caseswithsurgicaloperationweretreatedsuccessfully,nodeathbut1casewasreceivedsecondary
5、intervention.1caseofgaveupsurgerydiedofbloodlosswithin72h.Follow-upof3monthsto3years,8patientsreceivedfollow-up,1caseofgaveupsurgerywaslosttofollow-up.Of8patients,2patientswhowerereceivedendovasculartreatmentdiedbutthedeathswereunrelatedtoaneurysm,gluteuslimporlowerlimbpainin3cases,3c
6、aseswithoutanydiscomfortsymptoms.ConclusionThecavitytherapyandopenoperationareeffectiveintreatmentforrupturediliacarteryaneurysms.Thepatientswhocantoleraneesurgicaltreatmentaresuggestedtoreceivesurgeryactively.Therearemanycomplicationsofendovasculartreatmentrecently,thelong-termcompli
7、cationsremainstobefurtherobserved.【Keywords]Lliacaneurysms;Ruptured;Complications;Death;Treatment破裂骼动脉瘤(Rupturediliacarteryaneurysm,RIAA)是血管外科急危重症之一,早期就可发生致命性大岀血,临床死亡率高。据文献报道骼动脉瘤(Iliacarteryaneurysm,IAA)—旦破裂,如不及时进行治疗,患者生存率接近0,即使救治及时,其生存率也在50%左右,总的生存率在20%以下⑴。本文对我院2011年1月至2015年10月收治的10例
8、住院的RI