腹主动脉瘤患者不同术式围手术期的临床观察  

The study of different operative style for abdominal aortic aneurysm during surrounding operation

作　　者：岳文亮[1] 辛世杰[1] 张健[1] 肖亮[2] 胡海地[1] 胡新华[1] 杨德华[1] 张赞松[1] 段志泉[1] 徐克[2] 

机构地区：[1]中国医科大学附属第一医院普通外科教研室血管甲状腺外科,沈阳110001 [2]中国医科大学附属第一医院放射线科,沈阳110001

出　　处：《中华医学杂志》2010年第19期1309-1312,共4页National Medical Journal of China

基　　金：国家科技支撑计划课题（2007BAI05B04）

摘　　要：目的 比较腹主动脉瘤开放手术与腔内修复术围手术期的异同.方法 收集中国医科大学第一附属医院2004年1月至2009年4月间收治的经外科治疗的腹主动脉瘤患者,对其临床资料进行分析,比较腹主动脉瘤开放手术组（n=46）与腔内修复组（n=66）的术前状况、术中失血量、输血量、术中补液量、手术时间、ICU观察时间、住院时间、围手术期并发症及病死率.结果 腔内组术中平均失血量、输血量及术中补液量明显少于手术组（P＜0.05）,腔内组手术时间、术后ICU观察时间及术后住院时间明显短于手术组（P＜0.05）,但住院花费明显高于手术组（P＜0.05）,围手术期手术组术后并发症高于腔内组（P＜0.05）,在病死率上两组差异无统计学意义（P＞0.05）.结论 对围手术期患者研究证实腔内修复术具有创伤小,失血少,对人体内环境干扰少,术后恢复快的优点,近期疗效较开放手术好,尤其适合不能耐受开放手术的患者,但目前治疗费用仍较高.Objective To compare the the similarities and differences during the surrounding operation of endovascular repair （EVAR）and open surgical repair （OSR） for abdominal aortic aneurysm. Methods112 patients with abdominal aortic anenrysms （ AAA ） were selected from 2004 to 2009 ： among them, 66 patients were treated with EVAR, 46 patients with OSR. Data of two groups were collected and analyzed during surrounding operation. Results Compared to OSR group , the mean blood lost,bloed transfusion and intra-operative fluid in EVAR group were significantly less than OSR group（ P 〈0. 05 ）. The mean time of operation , observation period in ICU and being in hospital in EVAR group were shorter than OSR group（P 〈0. 05）. But the cost of hospitalization in EVAR was far higher than that of OSR group （ P 〈0. 05）. In short term postoperative complications the OSR group was higher than the EVAR （ P 〈0. 05）, however, there was no statistically significant difference in death rate of the two groups during surrounding operation（P 〉 0. 05）. Conclusion EVAR has the advantages of mild trauma, less blood loss,quicker recovery after operation, and less disturbance to internal environment. Especially, it is suitable for the patients who can not undergo open surgery repair,but its cost is still higher.

关 键 词：腹主动脉瘤 开放手术 腔内修复术 

分 类 号：R654.3[医药卫生—外科学]