腹主动脉瘤腔内治疗的合理化手术阈值探讨  

Discussion on the rationalization of surgical thresholds for endovascular treatment of abdominal aortic aneurysm

作　　者：张昊 陆清声 ZHANG Hao;LU Qingsheng(Department of Vascular Surgery,Changhai Hospital,Naval Medical University,Shanghai 200433,China)

机构地区：[1]中国人民解放军海军军医大学附属长海医院血管外科,上海200433

出　　处：《中国普通外科杂志》2024年第12期2069-2076,共8页China Journal of General Surgery

摘　　要：腹主动脉瘤(AAA)是血管外科的常见疾病,一旦发生破裂,病死率极高,对患者生命构成严重威胁。其主要治疗方式包括腹主动脉瘤腔内修复术(EVAR)和开放修复术(OR)。随着手术器械和技术的不断进步,EVAR已逐渐成为首选治疗方法。然而,EVAR与OR在手术原理及并发症方面存在显著差异,目前EVAR仍沿用为OR制定的手术指征,但这在一定程度上限制了EVAR的优势发挥。随着越来越多的临床研究证据表明,将AAA破裂风险和手术风险进行赋分量化后再比较,显然有助于更合理地制定个体化治疗方案。Abdominal aortic aneurysm(AAA)is a prevalent condition encountered in vascular surgery,characterized by a high mortality rate upon rupture,posing a serious threat to patients'lives.The primary treatment options include endovascular aneurysm repair(EVAR)and conventional open repair(OR).With advancements in surgical instruments and techniques,EVAR has gradually become the preferred method.However,EVAR and OR differ significantly in surgical principles and associated complications.EVAR continues to follow surgical indications originally developed for OR,limiting its full realization of its advantages.As clinical evidence continues accumulating,it has become increasingly clear that quantifying and comparing AAA rupture risk and surgical risk through scoring systems significantly aids in developing more rational and individualized treatment strategies.

关 键 词：主动脉瘤 腹 动脉瘤 破裂 血管内操作 手术指征 综述 

分 类 号：R654.3[医药卫生—外科学]