腹主动脉瘤近端瘤颈及瘤体形态对腔内修复术即时近端Ⅰ型内漏的影响  

THE INFLUENCE OF THE MORPHOLOGY OF PROXIMAL NECK AND ANEURYSM ON PROXIMAL TYPEⅠ ENDOLEAKS IMMEDIATELY AFTER ENDOVASCULAR ANEURYSM REPAIR

作　　者：祝金童 王豪夫[1] 李君[1] 荆冲[1] 

机构地区：[1]青岛大学医学院附属医院血管外科,山东青岛266003

出　　处：《青岛大学医学院学报》2015年第5期533-535,538,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨近端瘤颈及瘤体形态对腔内修复(EVAR)术近端Ⅰ型内漏发生的影响。方法收集在我院行EVAR术的肾下型腹主动脉瘤病人116例的术前CT动脉造影(CTA)资料,应用影像处理软件对其进行三维重建及相关指标的测量,分析近端瘤颈及瘤体形态与近端Ⅰ型内漏发生的关系。结果有15例病人术中出现近端Ⅰ型内漏,经综合处理后仅1例术后仍残留少量内漏。近端瘤颈长度(t=2.532,P<0.05)、瘤颈成角(t=2.086,P<0.05)及瘤体直径(t=4.254,P<0.001)、瘤体长度(t=4.286,P<0.001)均与近端Ⅰ型内漏的发生相关,但以上因素均不能单独准确预测近端Ⅰ型内漏的发生。结论术前对腹主动脉瘤形态进行精确测量及评估,术中积极处理,是防治近端Ⅰ型内漏的关键。Objective To evaluate the influence of the morphology of proximal neck and aneurysm on proximal typeⅠendoleaks after endovascular aneurysm repair（EVAR）. Methods Preoperative data of CT arteriography of 116 patients with infrarenal abdominal aortic aneurysm（AAA）underwent EVAR in our hospital were collected.Employing Osirix software,the data were reconstructed,the related indicators were measured,and the relationship between the occurrence of the proximal typeⅠ endoleaks and the morphology of proximal neck and aneurysm analyzed. Results Proximal typeⅠendoleaks occurred at surgery in15 patients,after a combined therapy,there was only one patient remained small endoleaks.The length of proximal tumor neck（t=2.532,P〈0.05）,infrarenal angle（t=2.086,P〈0.05）,diameter（t=4.254,P〈0.001）,and length（t=4.286,P〈0.001）of the aneurysm were correlated with proximal typeⅠ endoleaks,but any of the above factor alone could not accurately predict the occurrence of proximal typeⅠ endoleaks. Conclusion Accurate measurement and evaluation on the morphology of abdominal aortic aneurysm and active handling at surgery are the key to the prevention and treatment of proximal typeⅠ endoleaks.

关 键 词：主动脉瘤 腹 血管成形术 内漏 主动脉造影术 

分 类 号：R654.3[医药卫生—外科学]