CAJ | 학술논문

目的探讨老年腹主动脉瘤患者的l临床特点及围手术期处理策略. 方法回顾性分析我院24例60岁以上腹主动脉瘤手术患者的临床特点与围术期处理情况. 结果 24例患者平均年龄75.5岁;男女比例为5:1;病程2 d～15年,病程中位数为2.8个月;并存高血压17例、冠心病5例、2型糖尿病4例、慢性支气管炎3例、腔隙性脑梗死2例;腹主动脉瘤破裂患者3例;行带膜支架腔内隔绝术13例,腹主动脉瘤切除+人工血管置换术10例,带膜支架腔内隔绝术+右股动脉、右股深动脉内膜剥脱术+右股深动脉成形术+人工血管右股动脉一胭动脉搭桥术1例;术后并发症发生率为62.5%,病死率为20.8%. 结论老年腹主动脉瘤患者多伴有冠心病、高血压、糖尿病、慢性支气管炎等老年慢性疾病;老年腹主动脉瘤手术是一类高风险手术,合理的术式选择与围手术期处理是老年腹主动脉瘤患者治疗成功的关键.
목적 탐토노년복주동맥류환자적l림상특점급위수술기처리책략. 방법 회고성분석아원24례60세이상복주동맥류수술환자적림상특점여위술기처리정황. 결과 24례환자평균년령75.5세;남녀비례위5:1;병정2 d～15년,병정중위수위2.8개월;병존고혈압17례、관심병5례、2형당뇨병4례、만성지기관염3례、강극성뇌경사2례;복주동맥류파렬환자3례;행대막지가강내격절술13례,복주동맥류절제+인공혈관치환술10례,대막지가강내격절술+우고동맥、우고심동맥내막박탈술+우고심동맥성형술+인공혈관우고동맥일연동맥탑교술1례;술후병발증발생솔위62.5%,병사솔위20.8%. 결론 노년복주동맥류환자다반유관심병、고혈압、당뇨병、만성지기관염등노년만성질병;노년복주동맥류수술시일류고풍험수술,합리적술식선택여위수술기처리시노년복주동맥류환자치료성공적관건.
Objective To investigate clinical characteristics and perioperative management of abdominal aortic aneurysm in elderly patients. Methods The clinical data of 24 patients aged 60 years and over with abdominal aortic aneurysm in our hospital were analyzed retrospectively. Results The average age was 75.5 years and the proportion of male and female was 5 : 1. The course of disease was 2 days to 15 years and the median course was 2.8 months. 17 patients were complicated with hypertension, 5 patients with coronary heart disease, 4 patients with type 2 diabetes mellitus, 3 patients with chronic bronchitis, 2 patients with lacunar cerebral infarction, 3 patients with abdominal aortic aneurysm rupture, 13 patients with endovascular stent grafts, 10 patients with abdominal aortic aneurysm resection and artificial vascular replacement, 1 patient with endovascular stent grafts, endarterectomy of right femoral artery and right deep femoral artery,right deep femoral artery plasty and the application of artificial blood vessel in right femoro-popliteal arterial bypass. Postoperative complications happened in 15 cases (62.5%, 15/24) and the postoperative mortality rate was 20.8%.Conclusions The elderly patients with abdominal aortic aneurysm are always complicated with manyother chronic diseases such as hypertension, coronary heart disease , diabetes mellitus, chronicbronchitis. The operation for abdominal aortic aneurysm in elderly patients has high risk. Reasonablesurgical procedure and active perioperative management are the key for successful treatment.