介入封堵治疗与外科手术治疗主动脉窦瘤破裂的临床回顾分析

Clinical retrospective analysis of interventional closure and surgical treatment of ruptured aortic sinus aneurysm

目的探讨介入封堵治疗与外科手术治疗主动脉窦瘤破裂(RSVA)的疗效及预后。方法回顾性纳入2015年1月至2020年12月于武汉亚洲心脏病医院先心病中心确诊为RSVA的患者30例,分为介入封堵组和外科手术组,比较两组治疗效果。结果30例患者中,男18例,年龄16~75(38.5±14.6)岁。9例接受介入封堵治疗(介入封堵组),21例接受外科手术治疗(外科手术组),术中均未发生严重并发症,手术成功率均为100%。介入封堵组与外科手术组比较,瘤体破裂直径[(0.5±0.1)cm比(0.7±0.2)cm,P=0.018]更小,手术时间[(41±17)min比(215±47)min,P<0.001]、住院时间[7(6,8)d比14(11,15)d,P<0.001]更短,差异均有统计学意义。结论RSVA患者经积极治疗均可获得良好治疗效果。而对于破口直径小,且不合并其他心脏畸形的患者,介入封堵治疗能显著减轻患者手术痛苦,缩短恢复时间。

Objective To investigate the efficacy and prognosis of interventional closure and surgical treatment of ruptured aortic sinus aneurysm(RSVA).Methods Thirty patients with RSVA diagnosed in Wuhan Asia Heart Hospital from January 2015 to December 2020 were retrospectively included,and the clinical data of the patients were analyzed.Results There were 18 males among all 30 patients,with age of 16–75(38.5±14.6)years.Nine cases received interventional occlusion treatment and 21 cases received surgical treatment,no serious complications occurred during the operation and the success rate of the operation was 100%.Compared with the surgical group,the rupture diameter of the aneurysm in the interventional occlusion group was smaller[(0.5±0.1)cm vs.(0.7±0.2)cm,P=0.018],the operation time[(41±17)min vs.(215±47)min,P<0.001]and the length of hospital stay[7(6,8)d vs.14(11,15)d,P<0.001]were shorter than the surgical group.Conclusions Patients with RSVA can obtain good therapeutic effects after active treatment.For patients with smaller rupture diameter and no other cardiac malformations,interventional therapy can significantly reduce the patient’s surgical pain and shorten the recovery time.