经皮穿刺与股动脉切开主动脉腔内治疗早期疗效比较

Comparison of the early therapeutic effectiveness between total-percutaneous technique and open access to endovascular aorticrepair

目的:评价全穿刺技术与股动脉切开在主动脉腔内修复术的疗效差异。方法:随机选取血管外科行腔内治疗的肾下型腹主动脉瘤及非复杂性B型主动脉夹层共201例,对其中98例采用经皮穿刺术式,另103例采取股动脉切开,对比两组手术时间、伤口处理时间、术中出血量、手术费用、术后住院时间、并发症等情况。结果:两组患者年龄、性别、体质量指数、心血管危险因素、术中出血量及手术费用无统计学差异(P>0.05),在手术时间、伤口处理时间、术后住院时间以及并发症发生率上,经皮穿刺组显著低于股动脉切开组(P<0.05)。结论:经皮穿刺行主动脉腔内治疗,可减低术后住院时间、手术时间和伤口相关并发症,而手术费用无明显差异,可作为股动脉切开安全有效的替代术式。

Objective： To evaluate the efficacy of endovascular aorticreparir （EVAR） by totally percutaneous technique and surgical femoral exposure method. Methods： Two hundred and one patients with infrarenal aorta aneurysm or uncomplicated type B aorta dissection for endovascular repair were enrolled in this study. The patients were divided into PEVAR group （n=98） and OEVAR group （n=103）. The operation time, incision treatment time, intra-operative blood loss, surgery costs, postoperative hospital stay and complications were compared between two groups. Results： No significant difference was observed in the age, gender, BMI, cardiovascular risk factors, intra- operative blood loss and surgery costs between the two groups（P〉0.05）. Compared with OEVAR group, the operation time, incision treatment time, postoperative hospital stay and complication rates of PEVAR group were significantly decreased. Conclusion： Total percutaneous technique could reduce the operation time, incision treatment time, postoperative hospital stay and complication rates. However, the surgery costs remain the same as OEVAR. In summary,EVAR by totally percutaneous method could be a safe and effective replacement for traditional EVAR.