摘要
目的探讨开腹手术与腹主动脉瘤腔内修复术治疗腹主动脉瘤的远期效果。方法将腹主动脉瘤患者207例随机分为开腹手术组109例及腔内修复(EVAR)组98例,采取相应方式进行手术治疗,分别对2组进行至少5年的随访,比较2组患者生存率及免于再次手术率。结果 EVAR组院内病死率显著低于开腹组(P<0.05);2组院后随访病死率比较差异无统计学意义(P>0.05),均以心肺疾病为死亡的主要原因。在随访期间,开腹组患者免于再次手术率显著低于EVAR组(P<0.05),开腹组再次手术以伤口原因、局部或全身原因为主,EVAR组再次手术以移植物原因及局部或全身原因为主。结论与开腹手术比较,EVAR手术治疗腹主动脉瘤可有效降低院内病死率,却增加了远期的再次手术率,并不能有效提升远期生存率。
Objective It is to explore the long-term efficacy comparison of laparotomy versus endovascular repair of abdom- inal aortic aneurysm in abdominal aortic aneurysm. Methods 207 cases of abdominal aortic aneurysm patients were selected as research subjects. According to separate surgery they were divided into the abdominal surgery group （n = 109 patients） and endovascular repair （EVAR） group （ n = 98 patients） , two groups of patients were at least 5 years of followed-up, the survival rates and the freedom from reoperation rate were compared. Results The hospital mortality in the EVAR group was significantly lower than the open group （P 〈 0.05） ; the followed-up mortality after hospital in the EVAR group had no significant differ- ence with the open group （ P 〉 0.05 ） , the heart and lung disease was the leading cause of death. In the followed - up period, the freedom from reoperation rate in the open group was significantly lower than EVAR group （P 〉 0.05）, the again reopera- tion in the open group was operative wound reasons, local or systemic reasons of Lord, the re-operation reason in the EVAR group was graft reasons and local or systemic reasons based. Conclusion EVAR surgery in the treatment of abdominal aortic aneurysm and laparotomy relatively effective in reducing hospital mortality, reoperation rate has increased long-term, EVAR surgery does not effectively enhance the long-term survival.
出处
《现代中西医结合杂志》
CAS
2016年第25期2754-2757,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
开腹手术
腔内修复术
腹主动脉瘤
生存率
再次手术率
laparotomy
endovascular repair
abdominal aortic aneurysm
the survival rate, reoperation rate
