腹主动脉瘤开放和腔内治疗的合理选择

Rational choice of open or endovascular approach for abdominal aortic aneurysm

对腹主动脉瘤(AAA)的治疗,目前以开放手术及血管腔内修复术为主。如何选择合理的术式使患者得到更快且更安全的康复,是目前关注的焦点问题。笔者就两种方法的手术适应证、术前评估、并发症、病死率、生存率及成本效益进行对比,阐述了选择合理的术式的重要性,指出:目前既要不断提高血管腔内技术,也不能放弃传统的开放手术,应当根据自身技术水平及具体条件,严格掌握手术指征,本着为患者谋求最大治疗效果的目的客观地评价及选取最有利于患者的手术方式。

For abdominal aortic aneurysm （AAA）, open and endovascular repair are two currently available treatment methods. How to select an appropriate procedure so as to ensure a quick and safe recovery of the patients is now the focus of attention. In this paper, the scenarios that include the indications, preoperative assessment,complications, mortality and survival as well as cost-effectiveness of the two methods are compared, and the importance in rational choice of procedure is discussed. It is pointed out that there should be continual improvement in endovascular techniques while not abandoning the traditional open surger）5 and the most suitable procedure for the patients should be based on the surgeon＇s skills and prevailing conditions, rigorously following the surgical indications and objective evaluation with the purpose of achieving the greatest benefit for the patients.