开放手术与腔内介入手术在主动脉夹层和胸主动脉瘤治疗的应用情况  

Application of open surgery and endovascular intervention in the treatment of aortic dissection and thoracic aortic aneurysm

作　　者：熊莺[1] 龙思哲[1] 

机构地区：[1]中山大学附属第一医院病案管理科,广州510080

出　　处：《中国医院统计》2017年第1期9-11,16,共4页Chinese Journal of Hospital Statistics

基　　金：广东省医学科研基金(A2015362)

摘　　要：目的了解开放手术和腔内介入手术在主动脉夹层和胸主动脉瘤治疗的应用情况。方法采用回顾性分析方法及病案首页检索对447例行手术治疗的主动脉夹层和胸主动脉瘤住院患者病历资料进行相应的统计学分析。结果在主动脉夹层的手术治疗中,10年来开放手术构成比占29.97%,介入手术构成比占70.03%,介入手术逐年上升,而在胸主动脉瘤手术中,开放手术构成比占44.44%,介入手术构成比占55.56%(χ~2=6.821,P<0.01),近年来介入手术成为治疗主动脉夹层的主流。在主动脉夹层手术治疗中,介入手术治愈好转率96.00%,开放手术治愈好转率71,03%,χ~2=45.96,P<0.01,介入手术与开放手术用于治疗主动脉夹层治愈好转率有显著性差异。而介入手术与开放手术在胸主动脉瘤中应用的治愈好转率无差异(χ~2=0.125,P>0.05)。结论介入手术减少平均住院日、术前平均住院日、术后平均住院日、平均住院费用及平均药费,提高了主动脉夹层的手术治疗治愈好转率。Objective To know the service condition of the open surgery and the intravascular endovascular intervention- al procedures in aortic dissection and thoracic aortic aneurysm. Methods A survey was conducted by means of the retrospective method ahd medical records retrieval system and all data of 447 cases were analyzed statistically. Results In ten years of surgi- cal treatment of aortic dissection aneurysm, the proportion of open surgery accounted for 29.97% and the proportion of vascular interventional surgery accounted for 70.03%. The proportion of interventional surgery increased year by year. While in thoracic aortic aneurysm surgical treatment, the proportion of open surgery accounted for 44.44% and the proportion of vascular interven- tional surgery accounted for 55.56% （X2 = 6. 821, P〈0.01 ）. Interventional surgery has become the mainstream in the treatment of aortic dissection in recent years. In surgical treatment of aortic dissection, the cure rate of interventional surgery was 96%, and the cure rate of open surgery was improved by 71.03% （X2 =45. 96, P〈0.01 ）. The cure rate of interventional surgery was significantly different from open surgery. While there was no difference in the rate of cure and improvement between interventional surgery and open surgery in treatment of thoracic aortic aneurysm （X2 = 0. 125, P〉0.05 ）. Conclusion The intravascular endo- vascular interventional procedures decrease the average length of stay and postoperation or preoperation length of stay, average hospitalization expenses and average drug expenses. And it increases the cure and improvement rate in aortic dissecting aneu-rysm,

关 键 词：主动脉夹层动脉瘤 胸主动脉瘤 开放手术 腔内介入手术 治愈好转率 

分 类 号：R543.1[医药卫生—心血管疾病]