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目的：探讨破裂性腹主动脉瘤（rAAA）的急救经验及围手术期危险因素。方法：回顾性分析2007年1月—2015年9月间救治的27例rAAA患者的临床资料，其中男20例，女7例；中位年龄72岁；18例行开腹手术，6例腔内治疗（包括1例行杂交手术）。总结诊治过程、围术期情况及随访结果，并分析影响预后的因素。结果：术前死亡3例，术中死亡1例，术后死亡9例，术后死因有急性肾衰、急性呼衰、腹腔间隔室综合征、心肌梗塞、消化道出血，最终均出现多器官功能衰竭。总体抢救成功率为51.9%（14/27），开腹手术和腔内治疗成功率分别为50.0%（9/18）和83.3%（5/6）。围术期存活和死亡患者间的临床参数比较显示，发病到就诊时间、术前收缩压、术前肌酐、术中出血量及输血量、术中尿量的差异有统计学意义（均P<0.05）。结论：rAAA病情危重，病死率高，尽早确诊后应紧急外科治疗控制出血，加强围术期管理。在rAAA的救治中，腔内治疗是一种有效的治疗手段。“,”Objective:To review the experience in emergency treatment of ruptured abdominal aortic aneurysm (rAAA) and explore the perioperative risk factors. Methods:The clinical data of 27 patients with rAAA admitted from January 2007 to September 2015 were reviewed. Of the patients, 20 cases were male, and 7 cases were female, with a median age of 72 years;18 cases underwent open surgery and 6 cases had endovascular repair (including one case of hybrid surgery). hTe diagnosis and treatment procedures, perioperative conditions and postoperative follow-up results were summarized, and theperioperative risk factors were also analyzed. Results:Pre-, intra-and postoperative death occurred in 3, 1 and 9 cases respectively. hTe causes for postoperative death included acute renal failure, acute respiratory failure, abdominal compartment syndrome, myocardial infarction and hemorrhage of digestive tract, all which ifnally led to multiple organ dysfunction syndrome. hTe overall successful salvage rate was 51.9%(14/27), which in open surgery was 50%(9/18) and in endovascular repair was 83.3%(5/6), respectively. Comparison of the clinical variables between patients who survived and those who died during the perioperative period showed that there was signiifcant difference in time from onset to admission, preoperative systolic blood pressure, preoperative serum creatinine concentration, intraoperative blood loss, volume of transfusion and intraoperative urine output (all P<0.05). Conclusion:As rAAA is a lethal condition with high mortality, deifnitive diagnosis should be made as soon as possible to ensure emergent surgical repair to control the hemorrhage, and enhanced perioperative management is equally important. Endovascular repair is an effective approach for emergency treatment of rAAA.