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題名 | 腹主動脈瘤之手術危險因子、術後併發症與手術預後的探討=Risk Factors, Complications, and Survivals of Open Repair for Abdominal Aortic Aneurysms |
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作者姓名(中文) | 常傳訓; 鐘子雯; 李國楨; 張仙平; 莊義成; 蘇上豪; 張忠毅; 魏崢; |
作者姓名(外文) | Chang, Chuan-shun; Chung, Tzu-wen; Le, Kuo-chen; Ma, Frances C.; Chuang, Yi-cheng; Sue, Sung-how; Chang, Chung-yi; Wei, Jeng; |
書刊名 | 中華民國重症醫學雜誌 |
卷期 | 7:2 民94 |
頁次 | 頁52-60 |
分類號 | 416.263 |
語文 | chi |
關鍵詞 | 腹部主動脈瘤; 回溯性研究; 併發症發生率; 術後死亡率; Abdominal aortic aneurysm; AAA; Retrospective study; Morbidity rate; Mortality rate; |
中文摘要 | Objectives:探討腹主脈病患經過手術治療後併發症發生的情況、種類與病患死率的相關性,並比較破裂的腹主動脈病患與非破裂的腹主動脈病患其相關危險因子與術後併發症的發生情況。 Material and Mathods:本回溯性研究收集振興復健醫學中心從民國八十三年一月一日開始至民國九十三年六月三十日止,所有接受腹主動脈瘤切除之病患症歷。記錄病患包括性別、年齡、入院與出院時間、入院診斷、住院期間之併發症及相關疾病病史。手術相關因子包括病患手術的時間、動脈瘤直徑、手術前後的血壓值及手術過程中的輸血量。術後併發症的探討包括心臟及周邊血管、腸胃道、腎臟、肝臟、肺部方面的併發症紀錄,並以SPSS 10.0版統計軟體分析研究結果。 Results:本研究收集腹主動脈瘤切除的病患共66位,包含腹主動脈破裂的病擊12位與未破裂的病患54位。研究結果發現,破裂的腹主動脈瘤病患其動脈瘤直徑較大,有較明顯的的術前疼痛自覺症狀,手術時的出血量較高,術前血壓較低,加護病房的住院天及總住院天數較長,術後一個月與三個月的死亡率較高。術前疾病病史在破裂與未破裂的腹主動脈瘤病患並無差異性,但破裂的病患術後有較高的腸胃道出血及潰瘍的發生率。而術後有腸胃道併發症、腸胃出血、腸阻塞等其死亡的相對危險性較高。 Conclusions:腹主動脈的大小會影響病患術後住院天數,而動脈破裂的病患存在著較高的併發症發生率及術後死亡率。因此建議加強腹主動脈的疾病篩檢與術後腸胃狀況的監測,以期減少術後併發症的發生,進一步降低腹主動脈病患之死亡率。 |
英文摘要 | Objectives: Abdominal Aortic Aneurysm (AAA) is a disease with higher danger. If we can understand its complication and mortality rate after undergoing an operation of AAA, have its reference value in setting up the clinician’s therapeutically policy. Materials and methods: This retrospective research probe into the happened of AAA repair’s complications, hospital days and mortality rate. Comparing the differences of results and relative risk factors between ruptured and elective AAA. Results: We collected 54 elective AAA and 12 ruptured AAA patients. Ruptured patients with bigger aneurysm diameters, lower preoperation blood pressures, more pain feelings、bleeding amounts、ICU days、hospital days, higher morbidity of GI bleeding、ulcer and mortality in 1 and 3 months. The relative risk of death was significant in GI complications including GI bleeding and ileus. Conclusions: The size of AAA will affects the morbidiry and mortality rate of operation, and ruptured patients was in higher risk. We suggest increasing the screen of AAA and the monitor of postoperation GI complications to improve the outcome of operation. |
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