Abdominal aortic aneurysms: a clinical and autopsy study of 408 patients.
Abdominal aortic aneurysms: a clinical and autopsy study of 408 patients.
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腹主动脉瘤：408 名患者的临床和尸检研究。
DOI：
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
E. Vänttinen
中科院分区：
文献类型：
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作者：
Rantakokko;T. Havia;Markku V. Inberg;E. Vänttinen
资料包括1959-1969年（第一阶段）和1970-1979年（第二阶段）之间408例腹主动脉瘤患者。其中135个动脉瘤破裂，65个手术，70个尸检发现。尸检显示，在第一阶段，12/24（50%）因破裂而死亡的病例做出了错误的诊断；在第二阶段，6/46（13.3%）的类似病例诊断错误。第一阶段，16/26（62%）动脉瘤破裂；二期破裂病例49/129例（38%）。因破裂手术的患者平均年龄66岁（择期患者平均年龄64岁）。破裂病例的手术死亡率为63%(41/65)，其中11例患者在手术中死亡，30例患者在术后死亡，主要是由于原发性休克期的晚期后遗症或某种类型的心血管并发症。70岁以上患者的死亡率为89%；在年轻的年龄组中是49%。游离腹膜破裂患者全部死亡。术前休克、术中大出血及手术时间与手术死亡率高相关。在选择性病例中，医院死亡率为7%。心肌梗塞是最主要的死亡原因。死亡率与年龄、围手术期出血或手术时间无关。
The material consisted of 408 patients with abdominal aortic aneurysms between 1959-1969 (Period I) and 1970-1979 (Period II). Of the aneurysms 135 were ruptured of which 65 were operated on and 70 revealed at autopsy. Autopsy revealed that in Period I an incorrect diagnosis had been made in 12/24 (50%) of those cases in which rupture was the cause of death; in Period II an incorrect diagnosis was made in 6/46 (13.3%) of similar cases. During Period I, 16/26 (62%) of those operated on for aneurysms were rupture cases; during Period II rupture cases were 49/129 (38%). The mean age of patients operated on for rupture was 66 years (mean age of elective patients 64 years). The operative mortality rate in rupture cases was 63% (41/65): eleven of these patients died during the operation and 30 died during the postoperative period most often on account of late sequelae of the primary shock period or some type of cardiovascular complication. Among patients older than 70 years the mortality rate was 89%; in the younger age group 49%. All patients with free peritoneal rupture died. Preoperative shock, massive bleeding during the operation and duration of operation correlated with the high operative mortality rate. In elective cases the hospital mortality rate was 7%. Myocardial infarction was the most important cause of death. The mortality rate did not correlate with age, perioperative bleeding or the duration of the operation.