胸腹主动脉瘤39例诊治经验

Management of thoracoabdominal aortic aneurysm:experiences in 39 cases

目的对比胸腹主动脉瘤(TAAA)不同治疗方法的近中期效果方法回顾性分析2010年1月至2018年2月单中心39例TAAA患者的临床资料结果39例患者腔内治疗组25例、开放手术组11例、杂交手术组3例。腔内组平均年龄高于开放组(P<0.05)。腔内组出血fi及手术时间低于开放组和杂交组(P<0.05)=组手术成功率、术后30 d并发症率、再干预率方面差异无统计学意义(P>0.05)杂交组术后30d死亡率高于腔内组和开放组(P<0.05)腔内组并发症率高于开放组(P<0.05)结论腔内手术治疗TAAA具有操作时间短、创伤小、出血量少等优势,更适用于高龄患者,但远期并发症较多。

Objective To compare the efficacy and safety of different treatment methods for thoracoabdominal aortic aneurysm(TAAA).Methods The clinical data of 39 TAAA patients admitted to our department from Jan 2010 to Feb 2018 were retrospectively analyzed.Results There were 25 patients in endovascular group,11 in open group and 3 in hybrid group.The mean age in the endovascular group was significantly higher than that in the open group(P0.05).The blood loss and operation time in the endovascular group were significantly lower than those in the open group and the hybrid group(P<0.05).There was no significant difference in the operation success rate,the complication rate in post-operative 30 days and the rate of re-intervention(P>0.05)among the three groups.The post-operative 30 days mortality was significantly higher in the hybrid group than that in the endovascular group and open group(P<0.05).During the follow-up period,the complication rate in the endovascular group was significantly higher than that in the open group(P<0.05).Conclusion Endovascular surgery is more suitable for elderly patients because of shorter operation time,less trauma and bleeding.