摘要
目的对比破裂腹主动脉瘤腔内修复术与传统开放手术(OSR)治疗破裂腹主动脉瘤的临床疗效。方法收集2009年1月至2015年12月于四川大学华西医院收治的71例破裂腹主动脉瘤患者的临床资料。根据治疗方式的不同将患者分为腹主动脉瘤腔内修复术(EVAR)组(n=30)和OSR组(n=41)。比较两组患者的术前临床特征、手术情况和随访结果。结果两组患者的年龄、性别、吸烟情况、休克、糖尿病、原发性高血压、冠心病、心力衰竭、心脏瓣膜病、周围血管疾病、慢性阻塞性肺疾病、慢性肾功能不全、昏迷、瘤颈长度、瘤体最大直径、瘤颈角度比较,差异均有统计学意义(P<0.05)。EVAR组患者的手术持续时间短于OSR组患者,术中输血量和补液量均明显少于OSR组患者,差异均有统计学意义(P<0.05)。术后,两组患者的总体重症监护室(ICU)观察时间比较,差异有统计学意义(P<0.05)。EVAR组患者的围手术期病死率明显低于OSR组患者,差异有统计学意义(P<0.01)。EVAR组患者的再干预率为16.67%,高于OSR组患者的2.44%,差异有统计学意义(P<0.05)。两组患者术后1、3、6、12个月的生存率比较,差异无统计学意义(P>0.05)。结论EVAR治疗破裂腹主动脉瘤的手术时间更短,术后ICU观察时间更短,长期疗效与OSR类似,值得临床推广应用。
Objective To compare the clinical efficacy of traditional open surgical repair(OSR)and endovascular repair surgery of ruptured abdominal aortic aneurysms(RAAA).Method The clinical data of 71 cases of RAAA admitted to the emergency department of West China Hospital of Sichuan University from January 2009 to December 2015 were collected.The patients were divided into endovascular aneurysm repair(EVAR)(n=30)and OSR(n=41)according to their treatment modality.The preoperative clinical characteristics,surgery and follow-up results of the two groups were compared.Result There were significant differences in age,gender,smoking,shock,diabetes,essential hypertension,coronary heart disease,heart failure,heart valve disease,peripheral vascular disease,chronic obstructive pulmonary disease,chronic renal insufficiency,coma,tumor neck length,tumor diameter and neck angle ratio between the two groups(P<0.05).The surgery duration in EVAR group was shorter than that in OSR group,and the intraoperative blood transfusion and fluid replacement were significantly less than those in OSR group(P<0.05).After surgery,there was significant difference in the overall intensive care unit(ICU)observation time between the two groups(P<0.05).The perioperative mortality in EVAR group was significantly lower than that in OSR group(P<0.01).There intervention rate of patients in EVAR group was 16.67%,which was higher than 2.44%in OSR group(P<0.05).There was no significant difference between the two groups in the survival rate at 1,3,6 and 12 months after operation(P>0.05).Conclusion EVAR for RAAA has shorter surgery time,shorter postoperative ICU observation time,and long-term efficacy no less than that of OSR,and is worthy of clinical promotion and application.
作者
文鑫
赵纪春
黄斌
陈熹阳
罗新
郭强
杜晓炯
袁丁
Wen Xin;Zhao Jichun;Huang Bin;Chen Xiyang;Luo Xin;Guo Qiang;Du Xiaojiong;Yuan Ding(Department of Vascular Surgery,West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China)
出处
《血管与腔内血管外科杂志》
2021年第6期664-669,674,共7页
Journal of Vascular and Endovascular Surgery
基金
四川科技计划项目(2019JDRC0104)。
关键词
破裂腹主动脉瘤
腔内修复术
腹主动脉瘤腔内隔绝术
开放手术
临床疗效
ruptured abdominal aortic aneurysm
endovascular repair
endovascular exclusion of abdominal aortic aneurysm
open surgery repair
clinical efficacy
