24例肾动脉瘤治疗回顾性分析

Retrospective analysis on treatment in twenty-four patients of renal artery aneurysm

目的回顾性总结腔内修复与开放手术治疗肾动脉瘤的单中心经验。方法回顾性分析笔者所在医院2012年8月至2018年5月期间收治的24例肾动脉瘤患者的临床资料。其中9例行开放手术治疗(开放手术组),10例行腔内修复治疗(腔内修复组),初步分析2组患者的疗效;另外5例采取保守治疗,单独予以分析总结。结果 24例患者中女17例(70.8%),男7例(29.2%),选择手术的19例患者共23个动脉瘤均被成功修复。腔内修复组的平均住院时间(中位数)短于开放手术组:[10.5(P25 6.3,P75 15.0)d]比[21.0(P25 17.0,P75 27.5)d];开放手术组中1例患者术后11个月出现肾动脉狭窄,并进行再次手术,予以支架置入成功修复。2组的其余患者无明显的术后并发症出现。5例未手术患者在随访期间未发现瘤体明显增大或者破裂。结论开放手术和腔内修复手术均为有效的治疗肾动脉瘤的手段。肾动脉瘤若破裂可导致严重后果,因此一旦确诊,无论瘤体大小,建议应积极手术处理。

Objective To retrospective summarize the experience of endovascular repair and open surgery in the treatment of renal aneurysms in our single center.Methods Clinical data of 24 patients with renal aneurysm treated in our hospital from August 2012 to May 2018 were analyzed retrospectively.Nine patients undergoing surgical intervention were categorized as the open operation group,and ten patients who received endovascular repair were classified as the endovascular repair group.To compare and analyze the results of the two groups.Five patients who had refused surgery therapy will be analyzed separately.Results Twenty-four patients with seventeen females(70.8%)and seven males(29.2%)were enrolled in this study and nineteen patients with twenty-three aneurysms got repaired successfully.The endovascular repair group had shorter hospital stay compared with the open operation group[median:10.5(P25 6.3,P7515.0)d vs.21.0d].One patient in the open operation group developed renal artery stenosis at 11months after surgery and underwent reoperation by repair by successful stent placement.There were no other significant postoperative complications occurred in the two groups.No abnormal enlargement or rupture of the aneurysms were observed during the follow-up period in 5 unoperated patients.Conclusions Both open surgery and endovascular repair are effective means of treating renal artery aneurysms.Once the renal aneurysm ruptures,serious consequences will occur.Once a renal aneurysm is diagnosed,regardless of the size of the aneurysm,active surgical treatment is recommend.