中国实用外科杂志

中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (12): 1001-1003.

• 专题笔谈 • 上一篇    下一篇

炎性腹主动脉瘤诊断及治疗

黄新天   

  1. 上海交通大学医学院附属第九人民医院血管外科，上海200011
  • 出版日期:2012-12-01 发布日期:2012-11-29

  • Online:2012-12-01 Published:2012-11-29

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摘要：

炎性腹主动脉瘤（inflammatory abdominal aortic aneurysms，iAAA）是腹主动脉瘤的一种特殊类型，占腹主动脉瘤的2%~10%，其病因、发病机制仍然不清，病理特征为瘤壁增厚、瘤周广泛纤维化、腹腔内粘连。CT能可靠显示主动脉周围环状炎性物质，已逐渐变成诊断iAAA的主流方法。腹腔广泛的炎性纤维化使外科手术治疗iAAA存在较大风险，但血管腔内治疗使动脉瘤周围炎症改善，特别适合外科手术失败者。目前，血管腔内修复已被推荐为iAAA一线治疗方法。

关键词: 炎性腹主动脉瘤, 腔内修复术

Abstract:

Diagnosis and treatment progression of inflammatory abdominal aortic aneurysms        HUANG Xin-tian. Department of Vascular Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
Abstract    Inflammatory abdominal aortic aneurysms (iAAA) are a variant of aortic aneurysm characterized by extensive peri-aneurysmal fibrosis, thickened walls and dense adhesions and represent between 2% and 10% of all abdominal aortic aneurysms (AAA). The etiology of iAAA is understood poorly. Aneurysm development is multifactorial with important genetic and environmental factors. Computed tomography (CT) has become the mainstay of assessing iAAA. The perioperative mortality associated with open iAAA repair is increased compared with normal AAAs, largely due to intraoperative technical difficulties related to inflammation. Endovascular repair (EVAR) for iAAA results in successful management with improvement of periaortic inflammation. It is particularly useful when open repair has failed. EVAR should be considered as first-line therapy in which anatomic parameters are favorable.

Key words: inflammatory abdominal aortic aneurysm, endovascular aneurysm repair