The incidence of this kind of tumor is increasing year by year in Guangdong, which is like a “time bomb” in the body
Reporter of jinyang.com Peng Fuxiang, correspondent of fengxi.com Liang Jiayun
On the morning of August 24, the First Affiliated Hospital of Sun Yat sen University received a 70 year old male patient who was transferred from another hospital. Less than 10 minutes later, the man suddenly fell into a coma, abdominal swelling and dilated pupils. The patient died. It is understood that the patient suffered from abdominal pain 10 days ago and was diagnosed with ruptured abdominal aortic aneurysm. He went to two hospitals in Guangzhou for treatment, did not receive surgical treatment, and finally collapsed in the emergency room.
At the time of receiving the patient in the emergency room, the vascular surgery department of Zhongshan first hospital held a “large-scale free clinic for screening and prevention of abdominal aortic aneurysm” in the outpatient hall. Free color Doppler ultrasound examination was performed for 68 people at the scene, and 2 cases of abdominal aortic aneurysm like dilatation were screened.
Professor Chang Guangqi, Department of vascular surgery, Zhongshan first hospital, pointed out that the incidence of abdominal aortic aneurysm in Guangdong has increased year by year in recent years. Although it is a benign tumor, the risk is high. It usually occurs in middle-aged and elderly people. It has no symptoms before rupture. Once rupture occurs, it has a great chance of death, just like a “time bomb” in the body.
So, what is abdominal aortic aneurysm? Chang Guangqi said that it is not a “aneurysm” as we usually call it, but a “package” that bulges locally due to abnormal blood vessels. Under the impact of blood flow, the abdominal aortic wall expands or bulges. When the diameter reaches or exceeds 1.5 times of the original, it will be called abdominal aortic aneurysm. The disease is prevalent in people over the age of 60, with a incidence rate of 5/10000 to six, and more men than women. It is reported that 90% of this disease is caused by arteriosclerosis. In addition, hypertension, connective tissue diseases (such as Marfan’s syndrome, aortic middle layer dysplasia, etc.) can all lead to it.
Abdominal aortic aneurysm is almost asymptomatic and difficult to detect before rupture. So, who is prone to abdominal aortic aneurysm? The proportion of male to female is 4:1. Hypertension, hyperlipidemia, diabetes and long-term smoking may cause abdominal aortic aneurysm. In addition, previous history of femoral aneurysm, thoracic aortic aneurysm and other aneurysms were all high risk factors. Chang Guangqi suggested that people over 50 years old with high risk factors should be screened by abdominal vascular ultrasound regularly.
Find out abdominal aortic aneurysm, should operation be performed? Professor Yao Chen, Department of vascular surgery, Zhongshan first hospital, said that once the abdominal aortic aneurysm ruptures, the emergency rescue probability is only 50%, so he suggested early detection and early treatment. According to reports, when the diameter of abdominal aortic aneurysm is more than 5cm, surgical treatment is needed; while for women, because the diameter of abdominal aorta is too small, when the diameter of abdominal aortic aneurysm is more than 4.5cm, surgical treatment can be considered. In addition, no matter the size of the tumor, if the diameter of the tumor increases more than 5mm every six months, or if the tumor causes pain, compression or embolism symptoms, surgery should be performed in time.
Wang Jinsong, Professor of vascular surgery at Zhongshan first hospital, said that at present, there are two surgical methods for abdominal aortic aneurysm, one is traditional open surgery, the other is minimally invasive interventional surgery. Comparing the two kinds of surgery, Wang Jinsong said that the long-term treatment effect of traditional open surgery is exact, but the abdominal incision is huge, the operation time is long, the postoperative recovery is slow, and the incidence rate is more, the elderly patients with poor physical condition are difficult to tolerate. Interventional operation can avoid large abdominal incision, reduce surgical trauma and bleeding, shorten hospital stay, especially suitable for patients with severe cardiopulmonary insufficiency and other high-risk factors. She suggests that patients aged 50-60 are suitable for traditional open surgery and the treatment is more thorough, while interventional surgery is safer for patients aged over 70.
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During the interview, Professor Yao Chen introduced in detail the following diagnostic methods for abdominal aortic aneurysm: wpap60302br
1. Physical examination: pulsatile mass can be touched in abdomen. Detection is related to body shape: thin people are easy to touch, but sometimes the normal aortic pulsation is mistaken for aneurysm; obese people are not easy to touch, often missed diagnosis.
2. Color Doppler ultrasound: the most commonly used screening method. Advantages: noninvasive, easy to operate. Disadvantages: the accuracy is related to the operator’s proficiency, and the subjectivity is strong.
3. CTA: three dimensional imaging can be done, the results are accurate and reliable, and it is routinely used for preoperative and postoperative evaluation. However, it is not suitable for patients with iodine allergy and renal insufficiency. 4. Magnetic resonance imaging (MRA): it is often used in patients who are not suitable for CTA examination. 5. DSA: it can be used for diagnosis and treatment at the same time, and is often used for evaluation in minimally invasive surgery.