股动脉假性动脉瘤病因及治疗方法分析

Analysis of etiology and treatment of femoral pseudoaneurysms

目的探讨股动脉假性动脉瘤(FPA)病因与治疗方法。方法回顾性分析2005年1月至2014年12月收治的经临床及影像学证实的137例FPA患者的临床资料及随访资料。结果医源性FPA占63.5%(87/137),注射毒品性FPA占25.5%(35/137),外伤性FPA占9.5%(13/137),自发性FPA占1.5%(2/137)。保守治疗占54.0%(74/137),外科手术治疗43.8%(60/137),介入治疗占2.2%(3/137)。医源性与注射毒品性/外伤性FPA患者年龄分别为(67.6±11.7)岁和(39.2±10.9)岁,保守治疗与外科手术的FPA患者年龄分别为(64.3±14.6)岁和(48.1±17.6)岁,差异有统计学意义(P<0.05)。医源性FPA与注射毒品性/外伤性FPA的患者选择保守治疗概率分别为73.6%(64/87)和16.7%(8/48),差异有统计学意义(P<0.05)。出现症状后与影像学检查时间间隔15天内,医源性FPA与注射毒品性/外伤性FPA选择外科手术概率分别为24.7%(21/85)和81.8%(36/44),差异有统计学意义(P<0.05)。结论 FPA治疗方法选择,需结合病因、患者年龄、FPA的位置、破口等情况。

Objective To investigate the etiology and treatment of femoral pseudoaneurysms(FPA).Methods The data of 137 cases of FPA who diagnosed by clinic and imaging studies were analyzed retrospectively. Results Among 137 cases, the causes of FPA were iatrogenic factor(87 / 137), injection drug use(35 / 137), trauma(13 / 137) and spontaneous factor(2 / 137). Treatments for these FPA patients included conservative therapy(74 / 137), surgery(60 / 137) and interventions(3 / 137). The age of FPA patients caused by iatrogenic factor and by injection drug abuse / trauma was(67.6±11.7) years and(39.2±10.9) years, respectively, and the difference was statistically significant(P<0.05). The age of FPA patients treated by conservative therapy and surgery was(64.3±14.6) years and(48.1±17.6) years, respectively, and the difference was statistically significant(P<0.05). For FPA patients treated by conservative therapy, 73.6%(64 / 87) and 16.7%(8 / 48) cases were caused by iatrogenic factor and injection drug use / trauma, respectively,and the difference was statistically significant(P<0.05). If the imaging exams were done within 15 days after symptoms appearance of FPA patients, 24.7%(21 / 85) patients caused by iatrogenic factor and 81.8%(36 /44) patients caused by injection drug use / trauma were treated by surgery, and the difference was statistically significant(P<0.05). Conclusion The selection of treatment for FPA is related to the etiology, patient age,FPA's position, rupture site and so on.