32例破裂腹主动脉瘤治疗方法分析

Analysis of treatment method for 32 cases with ruptured abdominal aortic aneurysm

目的比较开腹手术和腔内隔绝术治疗破裂腹主动脉瘤的手术效果。方法 32例破裂腹主动脉瘤患者,其中23例行腹动脉瘤切除、人工血管移植术治疗(开腹组),9例行覆膜支架腔内隔绝术治疗(腔内隔绝组)。对两组患者术后围手术期死亡率进行比较,对发病至手术开始各时间段患者死亡率进行比较。结果两组死亡率比较差异均无统计学意义(P>0.05);但发病至手术各时间段患者死亡率比较差异均有统计学意义(P<0.05)。结论早期诊断是提高患者生存率的主要因素,正确评估破裂腹主动脉瘤是及时准确选择外科术式的前提。

Objective To compare the operation effects between laparotomy and endovascular graft exclusion in the treatment of ruptured abdominal aortic aneurysm. Methods Among 32 patients with ruptured abdominal aortic aneurysm, there were 23 cases undergoing abdominal aneurysm resection and artificial blood vessel transplantation （laparotomy group）, and 9 cases undergoing covered stent endovascular graft exclusion （endovascular graft exclusion group）. Comparisons were made on perioperative mortality and mortality of time points from disease attack to operation. Results There was no statistically significant difference of mortality between the two groups （P〉0.05）, while the difference of mortality of time points from disease attack to operation had statistical significance （P〈0.05）. Conclusion Early diagnosis is the main factor for improving patients survival rate, and correct assessment of ruptured abdominal aortic aneurysm is the precondition of timely and accurate operation.