首页> 美国卫生研究院文献>Annals of The Royal College of Surgeons of England >An audit of emergency abdominal aortic aneurysm repair to establish the necessity for an emergency vascular surgical rota.
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An audit of emergency abdominal aortic aneurysm repair to establish the necessity for an emergency vascular surgical rota.

机译:对紧急腹主动脉瘤修复进行审核以建立紧急血管外科轮换的必要性。

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摘要

Mortality for emergency abdominal aortic aneurysm (AAA) repair remains high but results of specialist vascular surgeons are superior to those of general surgeons. A retrospective audit was performed on all patients undergoing emergency AAA repair over 53 months at one hospital to determine the necessity for a vascular specialist on-call rota. Patients were stratified into two groups, those treated by specialist vascular surgeons and those treated by general surgeons. There were 37 patients in the vascular surgeon group and 36 in the general surgeon group. There was no significant difference between the two groups when age, sex distribution, APACHE II score on admission, pre-operative delay and type of rupture were considered. The average operating time was 114.7 min in the vascular surgeon group and 111.9 min in the general surgeon group. Total blood transfusion requirements, and postoperative duration of ventilation, inotrope therapy and intensive treatment unit stay were similar in the two groups. Intra-operative, 30-day and cumulative hospital mortalities were 10.8% versus 8.3%, 32.4% versus 38.9% and 40.5% versus 38.9% in the vascular surgeon and general surgeon groups, respectively. The mortality figures compare favourably with other published series. As the results of the two groups were similar, there is currently no need for vascular surgeons to be routinely available for acute AAA surgery at our hospital.
机译:紧急腹主动脉瘤(AAA)修复的死亡率仍然很高,但专科血管外科医师的结果优于普通外科医师的结果。对在一家医院进行了53个月以上急诊AAA修复的所有患者进行了回顾性审核,以确定有必要聘请有血管专科医生进行轮换。患者分为两组,分别由专科血管外科医师和普通外科医师治疗。血管外科医生组有37例患者,普通外科医生组有36例。在考虑年龄,性别分布,入院时的APACHE II评分,术前延迟和破裂类型方面,两组之间无显着差异。血管外科医生组的平均手术时间为114.7分钟,普通外科医生组的平均手术时间为111.9分钟。两组的总输血量,术后通气时间,药物治疗和强化治疗时间相似。血管外科医生组和普通外科医生组的术中,30天和累计住院死亡率分别为10.8%对8.3%,32.4%对38.9%和40.5%对38.9%。死亡率数字与其他已发表的数据比较。由于两组的结果相似,因此我们医院目前不需要常规的血管外科医师进行急性AAA手术。

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