破裂腹腔大动脉动脉瘤的管理:一个持续的挑战
Nicola Troisi1, Giulia Bertagna1, Lorenzo Torri1
1Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
Journal of clinical medicine
|September 9, 2023
概括
破裂的腹腔大动脉动脉瘤 (RAAA) 仍然是致命的. 集中化和风险评估改善了结果,但治疗选择和并发症仍然存在. 为了最佳的RAAA管理,需要进行进一步的研究.
科学领域:
- 血管外科 血管外科
- 大动脉动脉瘤管理管理
- 紧急医疗 紧急医疗
背景情况:
- 破裂的腹腔大动脉动脉瘤 (RAAAs) 尽管在选择性AAA治疗方面取得了进展,但仍是一个重大的死亡挑战.
- 最佳的外科手术 (开放 vs 内血管) 和对RAAA手术后并发症的管理仍然是关键问题.
研究的目的:
- 提供当代RAAA管理策略的概述.
- 突出影响RAAA患者治疗决策和治疗结果的术前和术后因素.
主要方法:
- 对MEDLINE,Embase和Scopus (1985-2023) 的综合文献搜索以及对SVS/ESVS指导方针的审查.
- 包括报告RAAA发生率,流行率,术前得分和紧急修复后死亡率的研究.
- 278篇选文章的叙事综合,没有研究设计限制.
主要成果:
- 集中RAAA护理改善了开放和内血管修复的结果.
- 术前风险评分和了解手术内因素可以帮助外科医生做出决策,尽管对最佳方法缺乏共识.
- 术后并发症仍然是RAAA幸存者的一个重大问题.
结论:
- 随着高死亡率,RAAA仍然是一个危及生命的紧急情况.
- 有效的患者查,集中护理和彻底的术前风险效益评估对于改善RAAA结果至关重要.
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