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目的 探讨内脏动脉瘤的诊断和治疗方法。方法 回顾性总结我院40 多年来收治的62 例内脏动脉瘤的临床经验。结果 本组包括肝动脉瘤15 例,胃胰十二指肠动脉瘤13 例,脾动脉瘤16 例,肾动脉瘤6 例,肠系膜上、下动脉瘤分别为5 例和1 例,腹腔干动脉瘤3 例,网膜动脉瘤3 例。本组自发性破裂大出血29 例,其中破裂入胆管14 例,上消化道10 例,腹腔及腹膜后5 例。本组术前经内脏动脉造影确诊37 例,经磁共振( MRI) 及数字减影血管造影术( DSA) 确诊各2 例,另6 例由螺旋CT 动脉造影(SCTA) 诊断。手术治疗51 例,死亡9 例,动脉栓塞治疗6 例。结论 内脏动脉瘤术前临床诊断极为困难,选择性内脏动脉造影( 包括DSA) 最具诊断价值,一旦确诊应尽早手术治疗
Objective To investigate the diagnosis and treatment of visceral aneurysms. Methods Retrospectively summarized the clinical experience of 62 cases of visceral aneurysms treated in our hospital for more than 40 years. Results The group included 15 cases of hepatic aneurysms, 13 cases of gastric pancreatic duodenal aneurysms, 16 cases of splenic aneurysms, 6 cases of renal aneurysms, 5 cases of superior mesenteric and inferior aneurysms, and 1 case of celiac artery. There were 3 tumors and 3 retinal aneurysms. There were 29 cases of spontaneous rupture hemorrhage in this group, including 14 cases of bile duct rupture, 10 cases of upper gastrointestinal tract, and 5 cases of abdominal cavity and retroperitoneum. In this group, 37 cases were confirmed by visceral artery angiography before surgery, 2 cases were diagnosed by magnetic resonance imaging (MRI) and DSA (digital subtraction angiography), and 6 cases were diagnosed by spiral CT angiography (SCTA). Surgical treatment of 51 cases, 9 deaths, 6 cases of arterial embolization. Conclusions Preoperative clinical diagnosis of visceral aneurysms is extremely difficult. Selective visceral arteriography (including DSA) is the most diagnostic value. Once diagnosed, it should be treated as soon as possible.