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中华普通外科学文献(电子版) ›› 2011, Vol. 05 ›› Issue (06) : 503 -507. doi: 10.3877/cma.j.issn.1674-0793.2011.06.010

所属专题: 文献

论著

肾下型腹主动脉瘤患者开腹手术死亡率多因素分析
江楠1, 肖亮灿1, 肖颖1, 张劲军1, 夏杰华1, 黄文起1,()   
  1. 1. 510080 广州,中山大学附属第一医院麻醉科
  • 收稿日期:2011-01-12 出版日期:2011-12-01
  • 通信作者: 黄文起

Factors affecting mortality after surgery for infrarenal abdominal aortic aneurysm surgery

Nan JIANG1, Liang-can XIAO1, Ying XIAO1, Jin-jun ZHANG1, Jie-hua XIA1, Wen-qi HUANG1,()   

  1. 1. Department of Anesthesiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2011-01-12 Published:2011-12-01
  • Corresponding author: Wen-qi HUANG
  • About author:
    Corresponding author: HUANG Wen-qi, Email:
引用本文:

江楠, 肖亮灿, 肖颖, 张劲军, 夏杰华, 黄文起. 肾下型腹主动脉瘤患者开腹手术死亡率多因素分析[J/OL]. 中华普通外科学文献(电子版), 2011, 05(06): 503-507.

Nan JIANG, Liang-can XIAO, Ying XIAO, Jin-jun ZHANG, Jie-hua XIA, Wen-qi HUANG. Factors affecting mortality after surgery for infrarenal abdominal aortic aneurysm surgery[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(06): 503-507.

目的

探讨影响肾下型腹主动脉瘤开腹手术死亡率的因素。

方法

回顾性分析我院1995~2006年102例择期行肾下型腹主动脉瘤切除并人工血管置换术患者的临床资料。

结果

患者择期手术的死亡率为6.67%(7/102),术中死亡的主要原因是失血性休克,术后死亡的主要原因为多器官功能衰竭。心血管病并发症与术后死亡率呈正相关性(P < 0.05)。

结论

加强麻醉期循环系统管理,可减少手术死亡率,提高腹主动脉瘤手术的安全性。

Objective

To investigate factors in affecting mortality after selective infrarenal abdominal aneurysm surgery.

Methods

Participants included 102 patients with a diagnosis of infrarenal abdominal aortic aneurysm in our hospital from 1995 to 2006. All of the patients underwent selective aneurysm resection and synthetic prosthesis replacement. Multivariable regression analyses were performed to examine the relation between surgery and mortality after surgery while controlling for baseline characteristics and early therapeutic interventions.

Results

The mortality rate was 6.67%, due in most cases to multiple organ failure. A significant correlation between the intraoperative cardiovascular complications and mortality existed in multivariable adjusted regression analyses (P < 0.05).

Conclusion

The improvement of anesthetic management of intraoperative circulatory system in selective infrarenal abdominal aneurysm surgery patients is associated with reduced mortality.

表1 术前和术中因素对主动脉瘤患者死亡率的影响(P值)
1
陈国锐, 林勇杰, 王深明, 等. 腹主动脉瘤100例外科治疗分析. 中华普通外科杂志, 2001,16(5):267-268.
2
Banke AB, Andersen JS, Heslet L, et al. Mortality and morbidity in surgery for abdominal aortic aneurysm. Ugeskr Laeger, 2008,170(43):3430-3434.
3
Podlaha J, Gregor Z, Roubal P, et al. Ruptured abdominal aortic aneurysm-outcomes in the years. Bratisl Lek Listy, 2002,101(4):191-193.
4
Piper G, Patel NA, Chandela S, et al. Short-term predictors and long-term outcome after ruptured abdominal aortic aneurysm repair. Am Surg, 2003,69(8):703-710.
5
Arko FR, Hill BB, Reeves TR, et al. Early and late functional outcome assessments following endovascular and open aneurysm repair. Endovasc Ther, 2003,10(1):2-9.
6
Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovaseular repair of ruptured abdominal aortic aneurysms: systematic literature review. Vascular, 2008,16(4):219-224.
7
Prinssen M, Verhoeven EL, Buth J, et al. Dutch Randomized Endovascular Aneurysm Management(DREAM)Trial Group: A randomized trial comparing conventional an d endovascular repair of abdominal aortic aneurysms. N Engl J Med, 2004,351(16):1607-1618.
8
Blankensteijn JD, de Jong SE, Pfinssen M, et al. Dutch randomized endovascular aneurysm management(DREAM) trial group: two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. New Engl J Med, 2005,352(23):2398-2405.
9
EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet, 2005,365(9478): 2179-2186.
10
司逸, 符伟国, 王玉琦. 腹主动脉瘤的腔内治疗进展[J/CD]. 中华普通外科学文献:电子版, 2008,2(5):49-52.
11
刘军麟, 殷梅. 腔内修复破裂的腹主动脉瘤手术死亡率:一个系统评价和Meta分析[J/CD]. 中华普通外科学文献:电子版, 2010, 4(2):161-168.
12
陈慕瑶, 朱琼芳, 陈旭素. 肾下型腹主动脉瘤切除并人工血管置换术的麻醉配合. 齐齐哈尔医学院学报, 2008,29(8): 988-989.
13
Torella F, Haynes SL, Kirwan CC. Acute normovolemic hemodilution and intraoperative cell salvage in aortic surgery. J Vasc Surg, 2002,36(1):31-34.
14
Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on periopemtive mortality and myocardial infarction in high-risk patients undergoing vascular surgery. N Engl J Med, 1999, 341(24):1789-1794.
15
Lubarsky DA, Fisher SD, Slaulter TF, et al. Myocardial ischemia correlates with reduced fibrinolytic activity following peripheral vascular surgery. J Clin Anesth, 2000,12(2):136-141.
16
宗林,李文献,邓小明. 腹主动脉瘤手术的麻醉. 国际麻醉学与复苏杂志, 2006,27(6):377-380.
17
Wozniak MF, LaMuraglia GM, Musch G. Anesthesia for open abdominal aortic surgery. Int Anesthsiol Clin, 2005,43(1):61-78.
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