UTICAJ PERIOPERATIVNIH FAKTORA NA ISHOD KOD PACIJENATA SA RUPTURIRANOM ANEURIZMOM ABDOMINALNE AORTE

Dajana Čović; Miloš Stjepanović; Milan Majkić; Dušan Tucaković; Nebojša Budakov; Vladimir Manojlović

doi:10.5937/smclk4-47314

Dajana Čović Opšta bolnica Subotica
Miloš Stjepanović JZU Bolnica "Sveti apostol Luka" Doboj
Milan Majkić Klinika za ortopedsku hirurgiju i traumatologiju, KCV
Dušan Tucaković Klinika za očne bolesti, UKCV
Nebojša Budakov Klinika za vaskularnu i transplantacionu hirurgiju, KCV; Univerzitet u Novom Sadu, Medicinski fakultet
Vladimir Manojlović Klinika za vaskularnu i transplantacionu hirurgiju, KCV; Univerzitet u Novom Sadu, Medicinski fakultet

DOI: https://doi.org/10.5937/smclk4-47314

Ključne reči: aneurizma, ruptura, abdominalna aorta

Sažetak

Uvod: Aneurizma je permanentno, lokalizovano proširenje dijametra arterije za minimum 50% u odnosu na njen fiziološki promer. Njena najčešća lokalizacija je na abdominalnoj aorti. Ruptura, kao najčešća komplikacija aneurizme, klinički je značajna jer je odlikuje visok stepen smrtnosti. Pacijenti sa rupturom aneurizme abdominalne aorte podvrgavaju se hitnom operativnom tretmanu gde su, uprkos naporima hirurga i ekspanzivnom napretku medicine i tehnologije, intraoperativni i postoperativni mortalitet i dalje zastupljeni u visokom procentu.

Cilj rada: Ispitati na koji način različiti perioperativni faktori utiču na ishod kod pacijenata sa rupturom aneurizme abdominalne aorte.

Materijal i metode: Retrospektivna studija zasnovana na medicinskoj dokumentaciji za dvogodišnji period, u okviru koje su deskriptivnim statističkim metodama obrađeni i analizirani perioperativni klinički parametri i njihov uticaj na ishod kod 57 pacijenata operisanih zbog rupture aneurizme abdominalne aorte.

Rezultati: Preoperativne vrednosti hemoglobina i komponenti hemostaznog sistema, intraoperativna nadoknada krvi i intraoperativni pH, kao i postoperativne vrednosti kalijuma, laktata i količina diureze u prva 24 sata nakon operacije, pokazali su statistički značajan uticaj na ishod kod pacijenata operisanih u Kliničkom centru Vojvodine zbog rupture aneurizme abdominalne aorte.

Zaključak: Operativni ishod kod rAAA je, uprkos dugogodišnjim istraživanjima perioperativnih faktora i pokušajem nalaženja idealnog skoring-sistema, i dalje nepredvidiv.

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