不同入路重建左锁骨下动脉的有效性和安全性比较

Comparison of the efficacy and safety of reconstruction of the left subclavian artery with different approaches

目的:探讨不同入路重建左锁骨下动脉(left subclavian artery,LSA)的有效性和安全性。方法:选取2017年5月至2020年6月,在遂宁市中心医院行体外预开窗治疗的102例患者,根据LSA重建入路的不同分为A、B两组。A组(47例)采用股动脉入路,B组(55例)采用肱动脉入路。比较两组手术成功率、手术时间,术后脑卒中、截瘫、内漏、伤口并发症及住院时间,并随访24个月观察两组并发症及生存结局。结果:A组的手术成功率为100%,明显高于B组91.9%(P<0.05)。同时,A组的手术时间明显短于B组,伤口并发症明显少于B组(均P<0.05)。两组间卒中、截瘫、内漏、术后住院时间及术后24个月并发症和生存情况,差异均无统计学意义(均P>0.05)。结论:经股动脉入路重建左锁骨下动脉具有成功率高、手术时间短及术后并发症少等优势,是一种值得推广的手术方式。

Objective:To investigate the effectiveness and safety of reconstruction of left subclavian artery(LSA)with different approaches.Methods:From May 2017 to June 2020,102 patients who underwent external prefeneination in Suining Central Hospital were selected and divided into two groups according to the different approaches of left subclavian artery reconstruction:Group A(47 cases)adopted femoral artery approach,and group B(55 cases)adopted brachial artery approach.The success rate,operation time,stroke,paraplegia,endoleakness,wound complications,length of hospital stay,postoperative complications and survival outcome were compared between the two groups.Results:The success rate of operation in group A was 100%,which was significantly higher than that in group B by 91.9%(P<0.05).At the same time,the operation time of group A was significantly shorter than that of group B,and the wound complications were significantly less than that of group B(all P<0.05).There were no significant differences between the two groups in terms of stroke,paraplegia,internal leakage,postoperative hospital stay,postoperative complications and survival(all P>0.05).Conclusions:Reconstruction of the left subclavian artery via femoral artery approach has the advantages of high success rate,short operation time and fewer postoperative complications,which is a worthy surgical method to be popularized.