1、破裂型腹主动脉瘤治疗策略哈尔滨医科大学附属第二医院血管外科姜维良 Vascular Surgery 2nd Teaching Hosp. Harbin Medical University,Harbin, Heilongjiang, ChinaAbdominal aortic aneurysm: A comprehensive REVIEWSourabh Aggarwal Alka Sharma MD . (India) Exp Clin Cardiol Vol 16 No 1 2011.w AAA发生的危险因素包括 : 年龄超过 60岁吸烟，高血压和白色人种。w 破裂危险因素为：动脉瘤尺寸，
2、增长速度，持续吸烟和持续性高血压。破裂型腹主动脉瘤治疗策略破裂型腹主动脉瘤治疗策略w 动脉瘤的年破裂率与直径的关系 :w Lessthan 4.0 cm 0%w 4.0 cm to 4.9 cm 0.5% to 5%w 5.0 cm to 5.9 cm 3% to 15%w 6.0 cm to 6.9 cm 10% to 20%w 7.0 cm to 7.9 cm 20% to 40%w 8.0 cm or greater 30% to 50%w Brewster DC, et al. w Guidelines for the treatment of abdominal aortic ane
3、urysms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg 2003;37:1106-17破裂型腹主动脉瘤治疗策略w AAA破裂严重威胁患者的生命w rAAA治疗每个环节都很重要，关系到抢救成功率。破裂型腹主动脉瘤治疗策略w 通过单因素和多因素回顾性分析 137例 rAAA的死亡危险因素：w 30天死亡率为 37%。w Open surgery in endo
4、vascular aneurysm repair era: simpliedclassication in two risk groups owing to factors affectingmortality in 137 ruptured abdominal aortic aneurysms (RAAAs)Stefano Bonardelli et al. （ Unit and Chair of Vascular Surgery, Universita degli Studi,A.O. Spedali Civili Brescia, Brescia, Italy ） Updates Surg (2011) 63:3944破裂型腹主动脉瘤治疗策略w 破裂性腹主动脉瘤分类w 限制性w 非限制性破裂型腹主动脉瘤治疗策略w 治疗阶段w 1.术前准备和急救w 2.治疗方案制定和手术实施w 3.术后治疗破裂型腹主动脉瘤治疗策略w 1.术前急救和手术准备rAAA诊断：典型 +腹部搏动性包块+腰背腹部疼痛+低血容量性休克破裂型腹主动脉瘤治疗策略w 急救措施w 抗休克 深静脉输液通道补充有效循环血量保护重要脏器功能
