腹主动脉瘤开腹手术与腔内介入治疗的比较

Abdominal aortic aneurysm treated by endovascular stent-graft and conventional surgical repair:a compa-rison

目的 评价腹主动脉瘤腔内介入治疗技术的可行性。 方法 对我院采用传统开腹手术的 32例和腔内介入治疗的 2 0例腹主动脉瘤患者的临床资料进行了回顾性分析。比较 2组患者治疗前的身体状况、手术所用时间、术中出血量、术后恢复状况和并发症发生情况。 结果 2组患者的性别、年龄分布、相关疾病、麻醉危险分级、动脉瘤分型及瘤体大小、手术成功率和病死率等差异无显著性意义 (P >0 0 5 ) ;腔内介入治疗组患者手术时间、术中出血量、术后ICU护理时间、饮食恢复时间、开始下地活动时间及住院时间均较传统开腹手术组患者明显减少 ,差异有显著性意义 (P <0 0 5 ) ,但术后并发症的发生率高于传统开腹手术组。术后并发症以内漏为主 ,并发症的发生与介入技术操作有关。 结论 腹主动脉瘤腔内介入治疗较传统开腹手术治疗具有创伤小、恢复快、住院时间短的优点 ,尤其适合不能耐受开腹手术的患者。但对该技术可能带来的并发症有待进一步探讨。

Objective[WT5”BZ] To evaluate the feasibility of abdominal aortic aneurysm(AAA) treated by endovascular stent graft. [WT5”HZ]Methods[WT5”BZ] The clinical data of 52 patients with AAA treated by endovascular stent graft( n =20) and conventional surgical repair( n =32) were analysed retrospectively. Patients conditions, operative hours, blood loss, function recovery and complications were compared. [WT5”HZ]Results[WT5”BZ] No significant difference was observed in sex, age, other disease, anesthesia risk category,aneurysm type, aneurysm diameter, technical success rate, and mortality rate between the groups( P >0 05).The patients who underwent intraluminal treatment had significant reductions in operative time, blood loss, intensive care unit and hospitalization. But there was a high complication rate in the endovascular stent graft group. All complications were connected with the interventional technique; endoleak was the chief complication after operation. [WT5”HZ]Conclusions[WT5”BZ] Endovascular treatment has marked merits such as reduced trauma, short hospitalization stays, and early functional recovery. It is sutable for the patients who can't undergo open surgical repair. But the complications caused by this technique needs further study. [WT5”HZ]