血管缝合器在老年腹主动脉瘤腔内修复术中的临床应用  

Clinical application of vascular closure devices in endovascular aortic repair of abdominal aortic aneurysm in elderly patients

作　　者：徐国雄[1] 许晨 俞靖凡 方昌文 张志轩[1] 金一琦[1] Xu Guoxiong;Xu Chen;Yu Jingfan;Fang Changwen;Zhang Zhixuan;Jin Yiqi(Department of Vascular Surgery,Suzhou Municipal Hospital Affiliated to Nanjing Medical University,Suzhou,Jiangsu,215008,P.R.China)

机构地区：[1]南京医科大学附属苏州医院血管外科,江苏苏州215008

出　　处：《老年医学与保健》2021年第6期1160-1163,共4页Geriatrics & Health Care

摘　　要：目的探讨血管缝合器配合经皮穿刺技术在老年腹主动脉瘤(AAA)腔内修复术(EVAR)中的安全性与有效性。方法回顾性分析2016年3月—2021年3月,南京医科大学附属苏州医院血管外科收治并行EVAR的老年AAA患者的临床资料。根据是否使用血管缝合器,将研究对象分为观察组(n=33)和对照组(n=30)。其中观察组应用Proglide血管缝合器封堵穿刺口,对照组行双侧股动脉切开并于术后缝合。记录2组的手术时间、入路建立时间、伤口处理时间、术后制动时间和术后住院时间;比较2组的技术成功率和术后并发症发生率。结果共纳入63例老年AAA患者,年龄71~90岁,平均(78.2±4.7)岁。2组的手术成功率和技术成功率均为100%。与对照组比较,观察组手术时间[(62.67±10.61)min vs(93.23±16.90)min]、入路建立时间[(10.18±2.69)min vs(33.70±3.29)min]、伤口处理时间[(6.33±0.72)min vs(27.24±3.34)min]、术后制动时间[(5.13±1.63)h vs(24.27±3.90)h]及术后住院时间[(3.97±1.16)d vs(9.70±2.20)d]减少,差异均有统计学意义(均P<0.001)。2组的并发症发生率差异无统计学意义(6.06%vs 6.67%,P>0.05)。结论血管缝合器配合经皮穿刺技术能够一定程度上缩短老年AAA患者的手术时间、入路建立时间、伤口处理时间、术后制动时间和术后住院时间,且术后并发症较少。Objective To explore the safety and effectiveness of vascular closure devices combined with percutaneous puncture in endovascular aortic repair(EVAR)of abdominal aortic aneurysm(AAA)in elderly patients.Methods The clinical data of elderly patients with AAA who were treated with EVAR in Department of Vascular Surgery,Suzhou Municipal Hospital Affiliated to Nanjing Medical University from March 2016 to March 2021 were analyzed retrospectively.They were divided into the observation group(n=33)and the control group(n=30)according to whether the vascular closure devices was used or not.The observation group used Proglide vascular closure devices to block the puncture port,and the control group underwent bilateral femoral artery incision and suture after operation.The operation time,approach establishment time,wound treatment time,postoperative immobilization time and postoperative hospital stay were recorded.The technical success rate and postoperative complication rate of two groups were compared.Results 63 elderly patients with AAA were enrolled,aged from 71 to 90,and the average was(78.2±4.7)years old.The surgical and technical success rates were 100%in both groups.Compared with the control group,the operation time[(62.67±10.61)min vs(93.23±16.90)min],approach establishment time[(10.18±2.69)min vs(33.70±3.29)min],wound treatment time[(6.33±0.72)min vs(27.24±3.34)min],postoperative immobilization time[(5.13±1.63)h vs(24.27±3.90)h]and postoperative hospital stay[(3.97±1.16)d vs(9.70±2.20)d]of the observation group were shorter,and the differences were statistically significant(P<0.001).There was no significant difference in the incidence of complications between the two groups(6.06%vs 6.67%)(P>0.05).Conclusion Proglide closure devices combined with percutaneous puncture can shorten the operation time,approach establishment time,wound treatment time,postoperative immobilization time and postoperative hospital stay of elderly AAA patients to a certain extent,and has fewer postoperative complication.

关 键 词：老年 腹主动脉瘤 腔内修复术 血管缝合器 

分 类 号：R654.3[医药卫生—外科学]