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目的 探讨特殊类型腹主动脉瘤(AAA)的诊疗方法 .方法 回顾性分析经手术治疗的31例特殊类型AAA的临床资料.结果 31例特殊类型AAA中,破裂型AAA(ruptured abdominal aortic aneurysnm,RAAA)17例,炎症性AAA(inflammatory abdominal aortic aneurysms,IAAA)4例,感染性AAA(mycotic abdomianl aortic aneurysms,MAAA)3例,结核性AAA 2例,累及肾动脉平面以上的AAA 5例.1例AAA破裂患者于急诊室抢救无效死亡,另30例中,施行紧急手术治疗16例,择期手术治疗14例.施行人工血管置换27例,支架型人工血管腔内微创治疗3例.无瘫痪、下肢动脉栓塞等并发症发生.术中及术后30d病死率为6%(2例).支架型人工血管腔内治疗的3例无漏血、移位等并发症发生,均痊愈出院.28例随访3个月至3年,均存活良好.结论 特殊类型AAA应积极手术治疗,改进传统手术方法 在技巧方面有利于提高手术的成功率;腔内技术的应用为其救治提供了新的方法 .“,”Objective To explore the management of particular types of abdominal aortic aneurysms ( AAA ). Methods The clinical data of 31 patients with particular types of AAA were reviewed retrospectively. Results Ruptured abdominal aortic aneurysms ( RAAA) were found in 17 cases, mycotic abdomianl aortic aneurysms ( MAAA ) , inflammatory abdominal aortic aneurysms (IAAA ) and tuberculous AAA. were found in 3 , 4 and 2 cases respectively. The lesions involved the suprarenal artery in 5 cases. One RAAA patient died of shock in emergency room. Emergency operation was done in 16 patients, elective operation in 14 cases. Replacement of the aneurysm by vascular prosthesis in 27 cases, and endoluminal treatment in 3 cases. Five cases developed mild postoperative complications. No paralysis or lower extremity arterial embolism occurred in any of the cases. Operative mortality was 6% (2 cases) . Twenty-eiggy patients were followed-up for 3 months to 3 years, all of the patients were living well. Conclusions Timely surgical therapy for particular types of AAA is important, traditional operation is still effective with improvement of surgical skills, and endoluminal therapy is a new modality gradually applied in the treatment of particular types of AAA.