腹主动脉瘤腔内修复术后并发症相关危险因素研究  

Risk factors of analysis of complications after endovascular repair for abdominal aortic aneurysm

作　　者：杨耀国[1] 陈忠[1] 寇镭[1] 唐小斌[1] 吴章敏[1] 刘晖[1] 王盛[1] YANG Yao-guo;CHEN Zhong;KOU Lei(Department of Vascular,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院血管科,北京100029

出　　处：《中国实用外科杂志》2021年第6期700-705,共6页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81870340);首都卫生发展科研专项(No.2018-1-2062)。

摘　　要：目的探究腹主动脉瘤病人行择期腹主动脉瘤腔内修复术(EVAR)后出现并发症的可能危险因素,为并发症的出现提供预警分析。方法回顾性分析首都医科大学附属北京安贞医院收治的286例行择期EVAR治疗的腹主动脉瘤病人资料,依据术后并发症的发生与否进行分组。比较有并发症的病人与无并发症病人在基线资料、动脉瘤解剖条件、术中情况及术前理化指标方面的差异。结果有并发症组与无并发症组在年龄、有无肝脏病史、术前白蛋白水平等方面差异有统计学意义(P<0.05)。通过Logistic回归分析发现,肝脏病史和术前血红蛋白水平与术后并发症的发生密切相关(P<0.05)。回归方程的ROC曲线下面积为0.614(95%CI 0.539~0.690,P=0.003)。结论既往存在肝脏病史和术前低血红蛋白水平对EVAR术后并发症的发生有预警意义。加强监测、及时纠正异常可能减少并发症的出现。Objective To explore the possible risk factors of complications after elective endovascular repair(EVAR)in patients with abdominal aortic aneurysm,and to give prediction for the occurrence of complications.Methods The clinical data of 286 patients with abdominal aortic aneurysm treated with elective EVAR in Beijing Anzhen Hospital,Capital Medical University were collected retrospectively and followed up,grouped according to the occurrence of postoperative complications or not.The differences in baseline data,aneurysm anatomical conditions,intraoperative conditions,physical and chemical indexes preoperatively were compared between patients with complications(CG)and those without(NCG).Results There were significant differences between CG and NCG in age,hepatic diseases,and preoperative hemoglobin level(P<0.05).Logistic regression analysis showed that hepatic diseases and preoperative hemoglobin level were closely related to the occurrence of complications(P<0.05).The area under the ROC curve of regression equation was 0.614(95%CI 0.539-0.690,P=0.003).Conclusion Previous liver history and low preoperative hemoglobin level are of early warning significance for the occurrence of complications after EVAR.Enhanced monitoring and timely correction of the abnormalities may reduce the occurrence of complications.

关 键 词：腹主动脉瘤 腔内修复治疗 并发症 

分 类 号：R6[医药卫生—外科学]