腹主动脉瘤开放手术时机选择

Opportunity of open surgical repair in abdominal aortic aneurysm

腹主动脉瘤瘤腔隔绝和动脉血管的重建是治疗腹主动脉瘤的核心概念,治疗的根本目的在于防止动脉瘤的破裂。手术指征的关键在于术前评估动脉瘤破裂危险性和病人全身状况。目前的治疗方法有传统的开放手术和近年迅速发展的腔内修复术。国外多中心研究发现虽然腔内治疗的近期效果较传统开放手术好,但两种治疗方法的中远期结果差异并无统计学意义。同时,对于特殊解剖形态的腹主动脉瘤,传统开放手术更具优势。因此,传统的开放手术治疗腹主动脉瘤仍具有临床应用的价值。

It is the core concept to exclude aneurysm and reconstruct the abdominal aorta for abdominal aortic aneurysm （AAA） treatment. The purpose of the treatment is to prevent aneurysm rupture. Evaluation of the risk of AAA rupture and the patients＇ condition are the key for the indication of operation. Open surgical repair （OR） and endovascular aneurysm repair （EVAR） are two treatments for AAA. Though the early result of the EVAR is better than that of the ORaccording to the multi-center clinical studies, the mid-result and long-result are the same between two treatments. For the hostile anatomy, OR is better than EVAR for AAA treatment. The OR still has the applicability for the AAA treatment.