abdominal aortic aneurysm treatment
zh *** What is the treatment of abdominal aortic aneurysm Disease description (main symptoms, onset time): My father worked 90 years in pancreatitis surgery, pancreatic surgery done 92 years of diabetes 94 years now, touch a few years ago with hard-edge feeling stomach, 7, 2008 25 to the hospital for ultrasound examination: the level of the abdominal aorta was about 1.7cm at the tumor-like expansion, expanding the length of 5.1cm, before and after the tibia 2.8cm, diameter 3.4cm, the lumen wall is not smooth, the wall is the thickest of about 0.4cm , CDFI: lumen expansion in blood red and blue signals, PD: positive and negative for the two-way flow is not obvious. The doctor asked observed In 2009 went to the hospital June 3 inspection, color Doppler ultrasound findings were: portal vein diameter of about 1.0cm. extrahepatic bile duct was no expansion. gallbladder size 5.0cm * 2.7cm, wall thickness of 0.53cm. intercostal not thick spleen, pancreas size is acceptable echo slightly increased in real terms. umbilical abdominal aorta above the level seen 6.1 cm vasodilation, vascular width 4.0cm, thickness 2.8cm, the blood flow seen in red and blue signals, the narrow and expansion at the visible color flow, expansion at the wall thickness of 0.45cm, and the thickness was uneven, the former smooth.And effectiveness of treatment was: untreatedTesting, inspection results (use the right tools to upload):Posted at Xu Shangdong doctor replies: What is the treatment of abdominal
2 # Zhen Hospital, Beijing, MD, associate professor, deputy director of cardiac surgeryHello!
Abdominal aortic aneurysm endovascular repair can be considered general or vascular replacement.
Please be enhanced CT or magnetic resonance, the film to us and give you advice.
Xu Shangdong cardiac surgery Xushang Dong Zhen Hospital, BeijingXu Shangdong Posted at my doctor
Treatment: surgery; cryotherapy; Radiation and Isotope Treatment; sclerotherapy; laser treatment; hemangioma copper acupuncture. 1. Surgical treatment: The surgical excision of the lesion method to achieve therapeutic purposes. for independent and small lesions good effect. In general, lesion area rich in blood vessels, a large amount of blood, a great amount of bleeding during surgery, often cause severe hemorrhagic shock, surgery required as input to whole blood, surgery difficult, high-risk. Also, because bleeding often can not be fully removed after the blood is forced to terminate the operation, it is the recurrence rate is high. surgical removal of part of the tumor and leave behind tumor local deformity, loss and dysfunction. expensive surgery , patients bear the burden of skin hemangioma facial cosmetic skin grafting may be repaired with lesion area. Therefore, surgical indications should be strictly controlled, weigh the value of surgery, and then determine whether the choice before surgery.
2. Cryosurgery: This method is used hemangioma (small superficial lesions can be as appropriate),
3. Radiation and Isotope Therapy: The treatment principle is the use of radioactive elements produced by r-ray of the lesion zone of bombardment to the nucleus where DNA chains, RNA-strand breaks, end nuclear protein synthesis causing cell death and dissolution, then through the tissue repair process for therapeutic purposes. clinically commonly used are: shallow X-ray irradiation, local irradiation of cobalt 60, strontium-40 film by bonding, such as phosphorus 32 colloid injection. treatment of radiation injury of the left part of post-treatment of atrophic scar, the epidermis has scaling phenomenon. For this radiation caused by the shrinkage of tissue and atrophic scars, experts recommend surgical removal of the purposes, or they will not rule out possible cancer. The experts believe that treatment in the course of treatment of vascular tumors as far as possible avoid the use of radiation therapy
Abdominal aortic aneurysm can not be self-healing, and if not treated in time, are often very easy to rupture leads to death. Therefore, a clear clinical manifestations of abdominal aortic aneurysm is the key to early diagnosis of the disease. The clinical manifestations of disease are: pulsatile abdominal mass. Most patients can be left in the Cullen and palpable pulsatile abdominal mass, and its sense of pulse with multi-directional expansion, while also associated with tremor and vascular murmur. pain. Most patients with only mild abdominal discomfort or pain, but when the tumor had eroded into the vertebral body or spinal nerve root compression occurs when the apparent low back pain. If sudden severe abdominal pain or low back pain, it is intra-abdominal tumor involving the artery or blood vessels caused by retroperitoneal bleeding signs. oppression of adjacent organs. Duodenum and proximal jejunum tumor suppression, can cause gastrointestinal symptoms; oppression of the ureter, it can lead to urinary tract obstruction; a minority of patients may occur due to tumor compression of common bile duct and obstructive jaundice. artery embolization. If you fall off endovascular thrombosis, can cause acute abdominal aortic occlusion the branch, such as mesenteric artery thrombosis, lower extremity arterial embolism, and can cause ischemic necrosis of the corresponding parts. aneurysm rupture. This is the most dangerous in patients with abdominal aortic aneurysm symptoms. Aneurysm rupture resulting in massive bleeding, these patients often die of hemorrhagic shock in a short time.
If the patient is suspected of suffering from abdominal aortic aneurysm, it can by ultrasonography, angiography or digital subtraction angiography of abdominal aorta (DSA) examination, CT examination and other imaging means to help diagnosis, but these tests can determine the aneurysm size, scope, aneurysm wall with or without atherosclerosis and thrombus, and the relationship between the tumor and its surrounding organs. Among them, ultrasound, especially below the level of the renal artery for the early diagnosis of abdominal aortic aneurysm.
When the patient was diagnosed with abdominal aortic aneurysms, it has to be treated aggressively, the only effective way of treating the disease is surgery. Patients with abdominal aortic aneurysm should be done on the principle of elective surgery, but those in poor tolerance to surgery, drug therapy should be actively pursued to improve the patient''s physical condition, to create favorable conditions for the operation. However, for tumor rupture, need immediate surgery.
In addition, ruptured abdominal aortic aneurysm and the tumor could have a direct relationship between the size of the diameter. Some studies have shown: that the tumor is less than 4 centimeters in diameter, the rupture rate is 10%; the tumor larger than 5 cm in diameter, less than 10 centimeters, the rupture rate is 30% to 50 %. The tumor diameter greater than 1O cm, the rupture rate is 80%. Therefore, current clinical tumor diameter of 5 cm will be implemented as a uniform standard of surgical treatment. But even the smaller the tumor, there is also the possibility of acute rupture. Therefore, patients with abdominal aortic aneurysm surgery as soon as possible or to. Patients with smaller tumors, imaging studies should be done on a regular basis (such as B-check), or if the increasing trend of the tumor, then surgery should be carried out to prevent serious consequences.
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