破裂腹主动脉瘤开放手术与腔内治疗早期疗效的分析  

Early result of endovascular aortic repair versus open surgery for ruptured abdominal aortic aneurysm

作　　者：邹君杰[1] 章希炜[1] 李林[1] 焦元勇[1] 蒋军[1] 杨宏宇[1] 马昊[1] 

机构地区：[1]南京医科大学第一附属医院血管外科,南京210029

出　　处：《中国血管外科杂志（电子版）》2017年第3期176-178,182,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的比较破裂腹主动脉瘤(r AAA)接受开放手术和腔内手术(EVAR)的早期疗效。方法回顾南京医科大学第一附属医院1998年1月至2017年6月间行急症手术治疗r AAA的31例患者临床资料。比较开放手术组和EVAR组病例的围术期死亡率、严重并发症发生率、出血量、输血量、ICU住院时间及总住院时间。结果开放手术组12例,围术期死亡率50%,术后发生严重并发症发生率58.3%;EVAR组19例,围术期死亡率21%,术后发生严重并发症发生率31.6%,二组围术期死亡率及严重并发症发生率无显著差异(P>0.05)。EVAR组在在术中出血量[(143.7±86.7)ml vs(3775.0±1801.1)ml]、输血量[(1331.6±967.3)ml vs(4158.3±1661.0)ml]、补液量[(2514.2±978.2)ml vs(4850.0±1306.3)ml]、术后ICU住院时间[(1.2±2.6)天vs(5.3±2.9)天]、总住院时间[(10.3±4.6)天vs(17.8±4.4)天]较开放手术组具有显著优势(P<0.05)。结论 EVAR是r AAA的一种有效治疗方法 ,但需要结合患者一般情况及动脉瘤解剖条件等因素综合考虑。Objective To compare the early result of endovascular aneurysm repair（EVAR） and open surgery for ruptured abdominal aortic aneurysm（r AAA）. Methods Clinical data of 31 r AAA patients treated in the First Affiliated Hospital of Nanjing Medical University from January 1998 to June 2017 were analyzed retrospectively. The difference between the EVAR group and the open surgery group in perioperative mortality, perioperative severe complication, ICU stay, length of hospital stay, amount of bleeding and blood transfusion were compared. Results Twelve patients were repaired by open surgery. Perioperative mortality was 50% and severe complication rate was 58.3%. Nineteen r AAA patients were repaired by EVAR.Perioperative mortality was 21% and severe complication rate was 31.6%. There was no significant difference between the two groups（P〉0.05）. Amount of bleeding [（143.7±86.7） ml vs（3775.0±1801.1） ml], blood transfusion [（1331.6 ±967.3） ml vs（4158.3 ±1661.0） ml], fluid infusion [（2514.2 ±978.2） ml vs（4850.0 ±1306.3） ml], duration of ICU stay [（1.2±2.6） days vs（5.3±2.9） days] and length of hospital stay [（10.3±4.6） days vs（17.8 ±4.4） days] were significantly different between the two groups（P〈 0.05）. Conclusion EVAR is an effective approach of the treatment for r AAA. However, the choice of treatment method for r AAA should be based on the patient conditions, anatomy and so on.

关 键 词：破裂腹主动脉瘤 腔内修复术 开放手术 

分 类 号：R654.3[医药卫生—外科学]