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| 篇名 |
Acutely Ruptured Abdominal Aortic Aneurysm: Experience in Chi Mei Hospital |
| 作者 |
Nan-Song Chou, Nan-Hua Chou, Hung-Jung Lin, Zhih-Cherng Chen, Bor-Chih Cheng |
| 卷期/出版年月 |
37卷2期 (2004/4) |
| 頁次 |
74-80 |
| 摘要 |
Objectives: The aim of this study was to identify the clinical features of, and
analyze the cause of successful operative therapy in, patients with acutely ruptured abdominal aortic aneurysm (AAA) in southern Taiwan.
Methods: Patients with an acutely ruptured AAA who reached hospital alive
between 1995 and 2001 were selected and analyzed retrospectively.
Results: Sixteen patients with an acutely ruptured AAA were identified and operated on. None had a known history of AAA. Abdominal pain and lower back pain
are the two most common manifestations. There were thirteen men and three
women. The mean age was 68.3 years (range: 52-84). The mean urine output
during the operation and day one after the operation were 2.3 1.7 ml/minute and
1106 434 ml/24 hours, respectively. The median interval between symptom onset
and hospitalization was seven hours, and that between hospitalization and operation was three and a half hours. Four patients died during hospitalization (hospital mortality rate: 25%). Of them, two patients died of hypovolemic shock during the operation and the other two died of multiple organ failure (MOF) 34 and 93 days after the operation respectively.
Conclusions: The urine output could herald the severity of shock and imply the
prognosis. Rapid diagnosis, appropriate resuscitation, and operation without any
delay to minimize the extent of ischemic damage to vital organs could prevent postoperative MOF and decrease postoperative death. To control bleeding immediately after exploration for avoiding intraoperative hypovolemic shock could decrease intraoperative death. |
| 關鍵詞 |
acute rupture, abdominal aortic aneursym, mortality, multiple organ failure |
| 分類 |
Case Report |
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