巨大腹主动脉瘤腔内治疗  

Endovascular treatment of giant abdominal aortic aneurvsm

作　　者：左健[1] 李凯[1] 郭坚[1] 王少玮[1] 孙子兰[1] 俞世强[1] ZUO Jian LI Kai GUO Jian WANG Shao- wei SUN Zilan YU Shiqiang(Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xian 710032, China)

机构地区：[1]第四军医大学西京医院心血管外科,710032

出　　处：《心肺血管病杂志》2016年第10期792-794,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的：总结巨大腹主动脉瘤腔内（AAA）隔绝治疗经验及中远期疗效。方法：2012年01月至2015年11月间，西京医院心血管外科采用经皮穿刺血管缝合器技术行血管腔内修复治疗巨大AAA47例，其中男性34例，女性13例，平均年龄67. 5岁（58 ～ 85岁），随访36 ～ 92个月，平均（56. 0 ± 10. 2）个月，每个病例均填写标准化（CＲF）表格，建立数据库，分析其临床特点及治疗效果。结果：术中1例近端少量I型内漏，球囊扩张后内漏基本消失;肺部感染1例，给予抗生素后好转，肾功能不全患者3例，给予透析治疗后肾功能恢复，肌酐、尿素氮指标正常。1例83岁患者术后24h后出现截瘫，给予康复锻炼后恢复，术后47例均临床痊愈出院。其中2例患者随访1年后死亡，死亡原因为急性心肌梗死和肺癌，病死率为1. 2%。结论：随着血管外科手术技术的不断改进和血管腔内修复技术的开展，巨大AAA手术的安全性将会不断提高。Objective： Summary huge abdominal aortic aneurysm endovascular exclusion treatment ex- perience and the long-term effect. Methods： January 2012 to November 2015 and Cardiovascular Surgery, Xi- jing Hospital, using percntaneous techniques endovascular treatment of large abdominal aortic aneurysm repair in 47 cases, of which 34 males and 13 females, mean age 67.5 years （58-85 years ） were followed up for36 to 92 months （ mean 56. 0 ± 10. 2 disabilities） months, each of the cases were filled standardization CRF tables, es- tablish a database to analyze the clinical characteristics and treatment effects. Results： Surgery in one case a small amount of proximal type I endoleak, after balloon dilation endoleak disappeared; one cases of pulmonary in- fection after antibiotics improvement in 3 patients with renal insufficiency, dialysis treatment given after recovery of renal function, creatinine, urea nitrogen signs. 1 case of 83-year-old patient after 24 hours after paraplegia, given rehabilitation exercises after recovery, 47 cases were clinically cured after surgery. Two patients were fol- lowed up for 1 year after the death, cause of death was Acute myocardial infarction and lung cancer, the mortality rate was 1.2%. Conclusion： With the development of the continuous improvement of vascular surgery and endo- vascular repair techniques and technology, huge abdominal aortic aneurysm security will continue to improve.

关 键 词：巨大主动脉瘤 腔内隔绝术 带膜支架 血管缝合器 

分 类 号：R54[医药卫生—心血管疾病]