37例内脏真性和假性动脉瘤腔内介入治疗的临床研究  

Clinical study on intraluminal interventional treatment of 37 cases of visceral true and false aneurysms

作　　者：刘哲 于凌 李宗蔚 张希全 窦树彬 Liu Zhe;Yu Ling;Li Zongwei;Zhang Xiquan;Dou Shubin(Neuroregulation Center,Shandong Mental Health Center,Ji'nan 250014,Shandong,China;Department of Vascular Surgery,960th Hospital of PLA Joint Logistic Support Force,Ji'nan 250000,Shandong,China)

机构地区：[1]山东省精神卫生中心神经调控中心,山东济南250014 [2]联勤保障部队第九六〇医院血管外科,山东济南250000

出　　处：《血管与腔内血管外科杂志》2025年第2期227-231,共5页Journal of Vascular and Endovascular Surgery

基　　金：山东省医药卫生科技发展计划项目(202109041050)。

摘　　要：目的探讨内脏动脉瘤(VAA)腔内介入治疗的方法和疗效,分析真性和假性动脉瘤的差异。方法收集2013年1月至2023年12月联勤保障部队第九六〇医院收治的37例VAA患者的临床资料,分析其基本信息、手术方式、治疗效果、并发症发生情况及随访结果。结果脾动脉受累最频繁。假性动脉瘤比真性动脉瘤的平均直径小。假性动脉瘤中与既往或活动性出血相关的发生率明显高于真性动脉瘤。既往或活动性出血的真性动脉瘤直径明显大于未出血的真性动脉瘤直径。有出血的假性动脉瘤与没有出血的假性动脉瘤大小无明显差异。VAA的介入治疗复杂多变,无固定的术式,需根据患者的临床表现和影像学特征选择治疗方案。技术成功率为100%。真性和假性动脉瘤在介入治疗方式上有不同倾向的选择,手术成功率、手术时间、住院时间无明显差异。介入治疗相关并发症的发生率为10.8%(4/37)。随访期间,1例进行覆膜支架置入的患者支架内狭窄率﹤30%,患者无明显的临床症状,其余患者的动脉瘤未复发,动脉内血流通畅,未发生弹簧圈异位、支架移位、变形等情况。结论腔内介入治疗VAA是一种安全、有效的方法,真性和假性动脉瘤在介入治疗方式上有不同倾向的选择,治疗效果无明显差异。Objective To investigate the methods and curative effects of endovascular interventional treatment for visceral artery aneurysm(VAA),and to analyze the difference between true and false visceral aneurysms.Method The clinical data of 37 VAA patients admitted to the 960th Hospital of PLA Joint Logistic Support Force from January 2013 to December 2023 were collected,their basic information,surgical methods,treatment outcomes,incidence of complications and follow-up results were analyzed.Result The splenic artery was most frequently affected.Pseudoaneurysms had smaller average diameter than true aneurysms.The incidence of false aneurysms associated with past or active bleeding was much higher than that of true aneurysms.The diameter of the true aneurysm with previous or active bleeding was significantly larger than the diameter of the true aneurysm without bleeding.However,there was no significant difference in the size of a pseudoaneurysm with bleeding and a pseudoaneurysm without bleeding.The interventional treatment of visceral aneurysms was complex and changeable,and there was no fixed surgical procedure.The treatment plan needs to be selected according to the patient's clinical manifestations and imaging characteristics.The technical success rate was 100%.True and false aneurysms have different tendencies in the choice of interventional treatment methods.There were no significant differences in surgical success rate,operation time,and hospital stay.The incidence of complications related to interventional therapy was 10.8%(4/37).During the follow-up period,1 case of covered stent implantation had stenosis<30%,and the patient had no obvious clinical symptoms.The aneurysms of the remaining patients did not recur,the blood flow in the arteries was smooth,and there were no abnormal position of the coil,stent displacement or deformation.Conclusion Endovascular interventional treatment of VAA is a safe and effective method.True and false visceral aneurysms have different tendencies in the choice of interventional surge

关 键 词：内脏动脉瘤 介入治疗 弹簧圈 覆膜支架 裸支架 

分 类 号：R543[医药卫生—心血管疾病]