高龄腹主动脉瘤患者传统手术和腔内治疗对照

Comparison of Open Surgery and Endovascular Treatment of Abdominal Aortic Aneurysms in Old Patients

目的 :对照 75岁以上高龄腹主动脉瘤患者传统手术及腔内治疗的疗效。方法 :回顾性分析 1998年以来复旦大学附属中山医院收治的 4 6例年龄大于 75岁腹主动脉瘤患者的治疗经验 ,其中传统手术 2 9例 ,腔内治疗 17例。结果 :两组术前情况基本相似 ,2 9例接受传统手术者围手术期有 4例死亡 ,17例行腔内治疗 ,无围手术期死亡。随访 8～ 6 9个月 ,2例死亡与腹主动脉瘤有关。累计生存率在传统手术组为 6 8.96 % (2 0 /2 9) ,在腔内治疗组为 82 .35 % (14 /17)。结论 :对于高龄腹主动脉瘤患者 ,在合适病例首选腔内治疗。

Objective: To compare the open surgery wit h the endovascular treatment of AAA in patients older than 75Y. Methods: 46 AAA cases aging from 75 to 90 in the past five years were reviewed. We performed open surgery on 29 patients and endovascular repair on the other 17 ones. Results: Preoperational general condition between two groups wer e similar. During peri-operation, there were 4 mortalities in the surgical group , while none in the endovascular group. 42 cases were followed up for 8-69 month s (average months). Only two death was related to AAA lesion. The accumulated su rvival rate was 68.96% (20/29)in the surgical group and 82.35% (14/17) in the en dovascular group, respectively.Conclusion:For octogenarians with AAA,the endovascular repair se ems preferable to suitable cases.