腹主动脉瘤开腹手术与腔内治疗的比较

Endovascular Repair Versus Open Surgery in Patients with Abdominal Aortic Aneurysm

目的:比较腹主动脉瘤腔内修复术与开放手术的疗效。方法:对35例肾下型腹主动脉瘤患者分别进行开放手术(21例)与腔内修复术(14例)治疗,比较两组术前评估、手术、围手术期及术后随访情况。结果:腔内修复组年龄较高(P<0.05),手术时间、术中出血量、输血量较开腹手术低(P<0.01),所需营养支持、监护、卧床时间短(P<0.01),围手术期并发症发生率低(P<0.05),但远期并发症发生率较高(P<0.05)。结论:腹主动脉瘤腔内支架治疗较为安全,创伤更小,患者恢复速度较快,适合于高龄及合并症较多的患者。传统开放手术适于年轻、合并症少及无法行腔内修复术的患者。

Objective To compare the therapeutic effect of endovascular aortic repair （EVAR） and open surgical repair （OSR） for treatment of abdominal aortic aneurysm.Methods Thirty-five patients with abdominal aortic aneurysm were treated by EVAR （n=14） and OSR （n=21）.The patients’ preoperative status,intraoperative variables,perioperative conditions,postoperative complications and survival rate were compared.Results The average age of the patients in EVAR group was older than that in OSR group （P〈0.05）.the operating time,the intraoperative blood loss and intrapoerative blood transfusion were less in EVAR group than in OSR group （P〈0.01）,And time observation in ICU,time for bedside activities and time to take in food were shorter in EVAR group （P 〈0.01）.The postoperative morbidity was lower in EVAR group （P〈0.05）,but with more complications on long term follow up （P〈0.05）.Conclusion EVAR is a safer and less traumatic method than OSR,and patients can recover more rapidly,it is suitable for patients of advanced age and those with more complication.OSR is suitable for younger patients and those with less complications or patients who can not undergo EVAR.