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目的:探讨使用腔内修复术治疗主动脉感染性假性动脉瘤的有效性。方法:回顾性分析2007年1月到2010年1月期间的主动脉感染性假性动脉瘤病人的临床资料,包括临床表现、治疗方式、治疗效果及预后。结果:6例病人(平均年龄53岁)均行腔内修复术。1例病人并发主动脉支气管瘘,1例病人并发主动脉十二指肠瘘,4例为肾下腹主动脉假性动脉瘤(其中1例于麻醉后出现包裹性破裂)。所有病人于术中均行隔绝成功,静脉使用抗生素1~4周伴随终身口服抗生素,平均住院22 d。围手术期无死亡及并发症。2例主动脉瘘的病人在随访期中死亡。1例病人术后随访发现并发腰大肌脓肿;其余病人在术后随访期间恢复良好。结论:腔内修复术可作为主动脉感染性假性动脉瘤病人挽救生命的良好选择,但主动脉支气管瘘或主动脉肠瘘等意味着持续性感染存在的可能,必须于术后严密随访,必要时需行进一步外科手术治疗。
Objective: To investigate the efficacy of endovascular repair in the treatment of aortic dissecting pseudoaneurysm. Methods: The clinical data of patients with aortic atypical aneurysm from January 2007 to January 2010 were retrospectively analyzed. The clinical manifestations, treatment modalities, therapeutic effects and prognosis were included. Results: Six patients (mean age 53 years) underwent endovascular repair. One patient had aortic bronchogenic fistula, one patient had aortic fistula, and four patients had a hypypical abdominal aorta false aneurysm (one of them had a package rupture after anesthesia). All patients were successfully isolated during operation. Intravenous antibiotics were administered with lifelong oral antibiotics for 1 to 4 weeks with an average hospitalization of 22 days. Perioperative death and complications. Two patients with aortic fistula died during follow-up. One patient was followed up for psoas major abscess. The rest of the patients recovered well during the follow-up period. Conclusions: Endovascular repair can be a good choice to save lives in patients with aortic aneurysm infection. However, aortic bronchogenic fistula or aortic intestinal fistula, which means the possibility of persistent infection, must be closely followed up after operation, If necessary, further surgical treatment is required.