腹主动脉瘤腔内修复术中血管缝合器与手术切开缝合临床应用对比研究

Comparation between blood vessel suture instrument and traditional surgical suture in EVAR surgery for abdominal aortic aneurysm: An analysis of 130 cases

目的探讨Perclose Proglide血管缝合器在腹主动脉瘤腔内修复手术中的应用及意义。方法回顾性分析2013年3月至2015年2月,首都医科大学附属安贞医院血管外科临床确诊腹主动脉瘤并实施腔内修复术的130例病人资料。术中采用穿刺股动脉方法建立入路并使用Perclose Proglide血管缝合器缝合69例(A组),手术切开股动脉并缝合61例(B组)。分析两组在缝合成功率、手术时间、术中出血量、住院时间、手术费用、伤口愈合情况、有无下肢缺血等因素,探讨Perclose Proglide血管缝合器在腹主动脉瘤腔内修复手术中的应用效果。结果在130例病人中,与手术切开组(B组)相比,使用缝合器组(A组)手术时间更短、术中出血量少、且住院时间较短,且差异均有统计学意义(P<0.05)。结论在腹主动脉瘤腔内修复手术中,经皮穿刺建立股动脉入路并使用Perclose Proglide血管缝合器处理穿刺点,该方法安全有效,且创伤小,病人术后恢复更快,值得推广使用。

Objective To investigate the application of the Perclose Proglide vascular closure devices in the endovascular abdominal aortic aneurysm repairing operation and its significance.Methods The clinical data of 130 cases of endovascular abdominal aortic aneurysm repairing operation performed between March 2013 and February 2015 in Department of Vascular Surgery,Beijing Anzhen Hospital of Capital Medical University were analyzed retrospectively.Among them,69 cases were treated with Perclose Proglide vascular closure devices to suture the puncture site of the femoral arteries and 61 cases were treated with the traditional surgical suture to close the puncture site of the femoral arteries.The relationship between the two groups and various clinicopathological factors of patients with abdominal aortic aneurysm were analyzed by Chi-square using statistical software SPSS17.0.The clinicopathological factors include operation successful rate,operation time,intraoperative blood loss,hospital stay,cost of operation,wound healing,lower limb ischemia and so on.Results Analysis using chi-square showed that Perclose Proglide vascular closure devices group was obviously better than the other group in operative time,intraoperative blood loss and hospital stay（P〈0.05）.Conclusion Comparing with the traditional surgical suture method,Perclose Proglide vascular closure devices are safe and effective.The patients have less injury and can recover more quickly.The Perclose Proglide vascular closure devices are worthy of clinical popularization.