腹主动脉假性动脉瘤开放手术和腔内治疗单中心经验分析  

Open surgery and endovascular treatment for abdominal aortic pseudoaneurysms:a single-center experience

作　　者：秦原森 姚陈[1] 胡作军[1] 王劲松[1] 王冕[1] 李梓伦[1] 王深明[1] 常光其[1] Qin Yuansen;Yao Chen;Hu Zuojun;Wang Jinsong;Wang Mian;Li Zilun;Wang Shenming;Chang Guangqi(Department of Vascular Surgery,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院血管外科,广州510080

出　　处：《中华血管外科杂志》2020年第4期233-237,共5页Chinese Journal of Vascular Surgery

基　　金：广东省自然科学基金博士启动项目(2016A030310133)。

摘　　要：目的总结腹主动脉假性动脉瘤行开放手术及腔内治疗的经验。方法回顾性分析2008年1月至2019年12月中山大学附属第一医院血管外科行开放手术或腔内治疗的25例腹主动脉假性动脉瘤患者的临床资料,其中11例行开放手术治疗(开放手术组),14例行腔内治疗(腔内手术组),对比分析两组围术期和随访期情况。结果腔内手术组围术期死亡率[0%(0/14)比18.2%(2/11)]和并发症发生率[(14.3%(2/14)比18.2%(2/11)]低于开放手术组,而腔内手术组的手术相关并发症率[35.7%(5/14)比27.2%(3/11)]、移植物感染率[14.3%(2/14)比0%(0/10)]、二次手术率[28.6%(4/14)比9.1%(1/11)]和总体不良事件发生率[50%(7/14)比27.2%(3/11)]高于开放手术组,但差异均无统计学意义(P均>0.05)。25例患者均获得随访,中位随访时间为20个月。随访期间,开放组无死亡病例,二次手术者1例。腔内手术组死亡2例,二次手术者3例。结论腔内手术和开放手术各有优缺点,应个体化选择治疗方式。Objective To summarize the experience of open surgery and endovascular treatment for abdominal aortic pseudoaneurysms.Methods A retrospective analysis was performed on clinical data of 25 patients with abdominal aortic pseudoaneurysms after open surgery or endovascular treatment at the Department of Vascular Surgery of the First Affiliated Hospital of Sun Yat-Sen University from January 2008 to December 2019.Among the patients,11 underwent open surgery treatment(open surgery group)and 14 with endovascular treatment(endovascular treatment group).The data of perioperative complications,secondary surgery complications related to the operation mortality rate and the overall incidence of adverse events,etc.were compared and analyzed.Results Compared with open surgery group,the perioperative mortality[0%(0/14)vs 18.2%(2/11)]and complication rate[14.3%(2/14)vs 18.2%(2/11)]of endovascular treatment group were lower than those of open surgery group,while the rate of complications related to the operation[35.7%(5/14)vs 27.2%(3/11)],the rate of graft infection[14.3%(2/14)vs 0%(0/10)],the rate of secondary surgery[28.6%(4/14)vs 9.1%(1/11)]and the overall incidence of adverse events[50%(7/14)vs 27.2%(3/11)]of endovascular treatment group were higher than those of open surgery group,but there were no significant differences(all P>0.05).Follow-up visits were performed on 25 patients,with a median follow-up time of 20 months.During the follow-up period,there was 0 death and 1 reintervention in open surgery group while in endovascular treatment group,there were 2 and 3 respectively.Conclusion Both endovascular treatment and open surgery have advantages and disadvantages.Therefore,individualized treatment approach should be adopted.

关 键 词：腹主动脉假性动脉瘤 腔内治疗 开放手术 

分 类 号：R654.3[医药卫生—外科学]