腔内与开放手术治疗腹腔干及其分支动脉瘤疗效对比分析

郭建明,谷涌泉,俞恒锡,陈 兵,郭连瑞,李学锋,齐立行,佟 铸,武 欣,张 建,汪忠镐

中国实用外科杂志 ›› 2013, Vol. 33 ›› Issue (12) : 1031-1033.

中国实用外科杂志 ›› 2013, Vol. 33 ›› Issue (12) : 1031-1033.
论著

腔内与开放手术治疗腹腔干及其分支动脉瘤疗效对比分析

  • 郭建明,谷涌泉,俞恒锡,陈    兵,郭连瑞,李学锋,齐立行,佟    铸,武    欣,张    建,汪忠镐
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摘要

目的    探讨腹腔干及其分支动脉瘤的外科治疗方法。 方法    回顾性分析首都医科大学宣武医院2002年2月至2012年12月外科治疗的20例内脏动脉瘤病人手术情况。20例中腹腔干动脉瘤1例、脾动脉瘤11例、肝右动脉瘤1例、胃左动脉瘤2例、胰十二指肠动脉瘤3例、胃十二指肠动脉瘤2例,其中破裂10例。14例行介入栓塞治疗,其余6例行开放手术。 结果    4例栓塞后再出血,1例行手术探查止血、3例行二次栓塞成功止血。7例动脉瘤破裂伴休克病人术后均停止出血。1例胰十二指肠动脉瘤栓塞后出现十二指肠不全梗阻。4例脾动脉瘤病人术后出现部分脾梗死。术后随访19例,随访4~130个月,无动脉瘤复发。 结论    对于腹腔干及其分支动脉瘤,腔内治疗和开放手术均安全有效,腔内治疗组可获得更短的住院时间。

Abstract

Therapeutic effect comparison between endovascular and open surgery of celiac artery and its branches arteries aneurysms        GUO Jian-ming, GU Yong-quan, YU Heng-xi, et al. Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Corresponding author: GU Yong-quan, E-mail:guyq66@sina.com
Abstract    Objective    To analyze surgical treatment methods of celiac artery and its branches arteries aneurysms. Methods    The clinical data of 20 patients performed surgery because of celiac artery and its branches arteries aneurysms from February 2002 to December 2012 in Xuanwu Hospital Capital Medical University were analyzed retrospectively. The celiac artery and its branches arteries aneurysms consist of 1 celiac trunk,11 splenic,1 right hepatic,2 left gastric,3 pancreaticoduodenal and 2 gastroduodenal aneurysms. Rupture occurred in 10 patients. Transcatheter arterial embolization was performed in 14 patients and other 6 patients were performed laparotomy. Results    Four patients suffered from recurrent bleeding after first embolization. One patient received exploring surgery to stop bleeding. Another 3 patients were performed second embolization. Bleeding was controlled rapidly in 7 patients in danger of rupture associated with shock. Duodenum incomplete obstruction developed in 1 patient after pancreaticoduodenal artery embolization. Another 4 patients suffered from partial splenic infarct after splenic artery operation. Nineteen patients were followed up for 4 to 130 months. No aneurysms recurred. Conclusion Both endovascular and open surgery for celiac artery and its branches arteries aneurysms are safe and effective. Endovascular procedure can get shorter length of stay.

关键词

腹腔动脉 / 内脏动脉瘤 / 血管内治疗

Key words

celiac artery / visceral artery aneurysm / endovascular procedure

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郭建明,谷涌泉,俞恒锡,陈 兵,郭连瑞,李学锋,齐立行,佟 铸,武 欣,张 建,汪忠镐. 腔内与开放手术治疗腹腔干及其分支动脉瘤疗效对比分析[J]. 中国实用外科杂志. 2013, 33(12): 1031-1033

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