CAJ | 학술논문

目的探讨脾动脉瘤的治疗方法及中远期疗效.方法 1999-2011年收治18例脾动脉瘤患者,对18例的治疗方法及预后等临床资料进行回顾性分析.结果 18例患者中男7例,女11例.平均年龄53.8±7.3岁.8例患者无临床症状于体检中发现,7例表现为左上腹疼痛,3例因动脉瘤破裂于急诊首诊.14例经三维血管造影(3DCTA)、3例经数字减影血管造影(DSA)、1例经磁共振血管造影(MRA)确诊.手术治疗11例,其中脾动脉瘤破裂行急诊手术3例,择期性手术8例.手术包括脾动脉瘤及脾切除4例,同时切除胰尾5例,脾动脉瘤切除、断端吻合1例,脾动脉瘤切除加脾及结肠脾区切除1例.另外,行脾动脉瘤介入栓塞治疗3例.本组中,4例无临床症状、且瘤体直径＜2 cm者行随访观察中.围手术期无死亡.随访16例平均3.2年.失访2例,1例于术后4年死于脑溢血.结论脾动脉瘤发病率低,症状多隐匿,脾动脉瘤破裂多有致死的危险.开腹手术及腔内微创治疗预后良好.
목적 탐토비동맥류적치료방법급중원기료효.방법 1999-2011년수치18례비동맥류환자,대18례적치료방법급예후등림상자료진행회고성분석.결과 18례환자중남7례,녀11례.평균년령53.8±7.3세.8례환자무림상증상우체검중발현,7례표현위좌상복동통,3례인동맥류파렬우급진수진.14례경삼유혈관조영(3DCTA)、3례경수자감영혈관조영(DSA)、1례경자공진혈관조영(MRA)학진.수술치료11례,기중비동맥류파렬행급진수술3례,택기성수술8례.수술포괄비동맥류급비절제4례,동시절제이미5례,비동맥류절제、단단문합1례,비동맥류절제가비급결장비구절제1례.령외,행비동맥류개입전새치료3례.본조중,4례무림상증상、차류체직경＜2 cm자행수방관찰중.위수술기무사망.수방16례평균3.2년.실방2례,1례우술후4년사우뇌일혈.결론 비동맥류발병솔저,증상다은닉,비동맥류파렬다유치사적위험.개복수술급강내미창치료예후량호.
Objective To assess the treatment of splenic artery aneurysms (SAA) and prognosis.Methods Clinical data of 18 SAA patients treated in our hospital from 1999 to 2011 were retrospectively analyzed. Results There were 18 patients diagnosed as SAA,including 7 males and 11 females.The average age was 53.8 ± 7.3 years.8 patients were asymptomatic found by routine physical examination,7 patients complained upper left abdominal pain,3 cases suffered from aneurysm rupture. Diagnosis was established by three-dimensional computed tomography angiography (3DCTA) in 14,Digital subtraction angiography (DSA) in 3 and magnetic resonance angiography (MRA) in 1 patient.Three patients with ruptured splenic artery aneurysm underwent emergent operations,11 patients underwent elective surgery or interventional therapy.Surgical procedures included aneurysmectomy and splenectomy in 4 patients,distal pancreatectomy in 5 cases; aneurysmectomy and splenic artery ligation in one patient; and aneurysmectomy with splenectomy and colon resection in 1 case.Interventional embolization by coils of the splenic aneurysm in 3 patients.The remaining 4 being asymptomatic and with tumor diameter less than 2 cm were put on a close follow-up.There was no perioperative mortality.Two were lost to follow-up.16 cases were followed-up for averaging 3.2 years. 1 patient died of cerebral hemorrhage after four years. Conclusions Splenic artery aneurysms was a rare disease and with usually occult symptoms,but rupture can leads to abdominal apoplexy.Open surgery and minimally invasive endovascular treatment is effective and offers a good prognosis.