腹主动脉瘤腔内修复术后瘤体直径及体积变化的随访研究  

Changes in aneurysm diameter and volume after endovascular aneurysm repair of abdominal aortic aneurysm

作　　者：钟林堃 李昶 刘池拽[1] 张明光[1] 何瑜 谭力 师天雄[1] 缪健航[1] 王折存 ZHONG Linkun;LI Chang;LIU Chizhuai;ZHANG Mingguang;HE Yu;TAN Li;SHI Tianxiong;MIAO Jianhang;WANG Zhecun(The Second Department of General Surgery,Zhongshan City People’s Hospital,Zhongshan 528403,China;Department of Vascular Surgery,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山市人民医院普外二科,广东中山528403 [2]中山大学附属第一医院血管外科,广东广州510080

出　　处：《广州医药》2023年第9期34-39,共6页Guangzhou Medical Journal

基　　金：中山市卫生健康局医学科研项目(2021J107)。

摘　　要：目的探讨腹主动脉瘤腔内修复术后瘤体直径和瘤体体积的转归以及与术后内漏的关系。方法回顾性分析2015年-2020年在我院行腹主动脉瘤腔内修复术的83例患者的临床及影像学资料。测量术前和术后各随访时间点瘤体最大直径及体积。CT评价术后内漏发生情况。定义瘤体(直径/体积)扩张/回缩及瘤体(直径/体积)稳定。以术前瘤体最大直径大小和术后内漏发生情况将患者分组,比较组间各随访时点的瘤体直径和体积转归情况。结果患者术后平均随访时间24(10~62)个月。以瘤体直径<50 mm及≥50 mm分组,术后各随访时间点2组间瘤体体积及瘤体直径比较均无统计学差异。以术后有无内漏分组,术后各随访时间点组间比较瘤体体积变化比较差异均有统计学意义(P<0.05),但瘤体直径变化组间比较差异均无统计学意义。结论主动脉瘤瘤体体积与直径变化并不存在一致性,监测瘤体体积可以发现那些直径变化不明显的瘤体变化;腹主动脉瘤腔内修复术后内漏可能是导致瘤体增大的因素之一。Objective To evaluate the outcome of aneurysm diameter and volume,and the role of endoleak after endovascular aneurysm repair of abdominal aortic aneurysm.Methods The clinical and imaging data from 83 patients who underwent endovascular repair of abdominal aortic aneurysm in our hospital from 2015 to 2020 were retrospectively analyzed.The maximum aneurysm diameter and volume were measured at the preoperative and postoperative follow-up time points.CT was used to evaluate the incidence of postoperative leakage.The aneurysm(diameter/volume)expansion/shrinkage and aneurysm(diameter/volume)stability were defined.Patients were divided into different groups according to the maximum preoperative aneurysm diameter and the incidence of postoperative endoleak,and the outcomes of aneurysm diameter and volume were compared at established follow-up points.Results The mean follow-up time was 24(10-62)months.There were no statistically significant differences in postoperative aneurysm volume and diameter at follow-up points between the patients with aneurysm diameter<50 mm and patients with aneurysm≥50 mm.There were statistically significant differences in postoperative aneurysm volume between the patients with postoperative endoleak and patients without postoperative endoleak(P<0.05).However,there were no statistically significant differences in postoperative diameter between the two groups.Conclusions The changes of aneurysm volume and diameter were not closely related,and the detection of aneurysm volume can help to find the aneurysm changes with no obvious diameter changes.The postoperative endoleak after endovascular aneurysm repair may be one of the factors leading to aneurysm enlargement.

关 键 词：腹主动脉瘤 腔内修复术 瘤体体积 瘤体直径 内漏 

分 类 号：R654.3[医药卫生—外科学]