腹主动脉瘤腔内修复术单中心治疗经验  

Endovascular repair of abdominal aortic aneurysm： a single center experience

作　　者：陈忠[1] 杨耀国[1] 唐小斌[1] 吴章敏[1] 寇镭[1] 刘晖[1] 王盛[1] 李庆[1] 张征[1] 贾云峰[1] 何楠[1] 吴庆华[1] 

机构地区：[1]首都医科大学附属北京安贞医院血管外科,北京100029

出　　处：《中华普通外科杂志》2011年第11期892-894,共3页Chinese Journal of General Surgery

基　　金：首都医学发展科研基金资助项目（2007-1027）

摘　　要：目的评价腔内修复术（endovascular aneurysm repair，EVAR）治疗肾下型腹主动脉瘤（ abdominal aortic aneurysm, AAA）的围术期和中远期效果。方法回顾性分析131例AAA行EVAR的临床资料，评价EVAR治疗AAA的安全性和中远期疗效。结果手术时间（137±29）min，术中出血（142±20）ml、输血（46±26）ml、ICU恢复时间为（17±4）h。围术期主要并发症包括重度心功能不全8例、心肌梗死2例、肺部并发症5例，内漏4例等；随访中发现内漏15例，Ⅰ型8例，Ⅱ型5例，Ⅲ型和Ⅳ型各1例，死亡2例；Kaplan—Meier生存分析无并发症生存率及再次处理率提示60个月后仍有并发症发生，其中40％是需要再次处理的并发症。结论EVAR是AAA的安全治疗方法，但需要长期严格随访并及时处理并发症。Objective To evaluate the perioperative and long-term effects of endovascular aneurysm repair （EVAR） of infrarenal abdominal aortic aneurysm （AAA）. Methods Clinical data of 131 AAA cases undergoing EVAR were retrospectively evaluated for the safety and long-term efficacy. Results The operative time was （ 137 ± 29 ） min, blood loss was （ 142 ± 20 ） ml, blood transfusion was （46 ± 26） ml, ICU staying time was （17±4） h. Major perioperative complications were severe heart failure in 8 cases, myocardial infarction in 2 cases, pulmonary complications in 5 cases, internal leakage in 4 cases. During the period of up to 60 months there were15 cases of endoleak including 8 cases of type I , 5 cases of type II , 1 each case of type III and IV and 2 deaths. By Kaplan-Meier survival analysis there were complications developing after 60 months and up to 40% of them needing reintervention. Conclusions Endovascular repair is the safe treatment for AAA, but discharged patients need close long-term follow-up. Complications that ensued need intensive management.

关 键 词：主动脉瘤 腹 支架 腔内治疗 

分 类 号：R654.3[医药卫生—外科学]