摘要
目的 比较有症状性腹主动脉瘤和无症状性腹主动脉瘤腔内修复术的围手术期结果.方法 回顾性分析2008年1月至2013年2月符合纳入排除标准的230例进行腹主动脉瘤腔内修复术的非破裂性腹主动脉瘤患者临床资料.其中有症状性腹主动脉瘤43例（18.7％）,男性40例,女性3例,平均年龄（69±10）岁;无症状性腹主动脉187例（81.3％）,男性162例,女性25例,平均年龄（71±9）岁.于术后1个月进行随访.主要研究内容是围手术期全因死亡,次要研究内容是手术相关数据、主要围手术期不良事件.结果 有症状组与无症状组在年龄、性别、美国麻醉师协会评分、基础疾病等方面差异无统计学意义.有症状组瘤径较无症状组更大[6.00（1.97）cm比5.10（1.70）cm,Z=2.51,P=0.01].围手术期全因病死率分别为0和1.1％（P=0.66）,技术成功率和临床成功率两组均为100％,其他手术相关数据两组结果差异无统计学意义.包含死亡的主要围手术期不良事件发生率分别为0和2.1％（P=0.43）.结论 腔内治疗有症状性腹主动脉瘤和无症状性腹主动脉瘤围手术期结果相似,但需要更多的研究进一步比较中长期结果.
Objective To compare the perioperative outcome after endovascular repair （EVAR） of symptomatic abdominal aneurysms （S-AAAs） and elective non-symptomatic AAAs （E-AAAs）. Methods From January 2008 to February 2013, a total of 230 non-ruptured AAA patients treated by EVAR met the inclusion criteria. S-AAAs were present in 43 （ 18. 7% ） patients, 40 patients were male, 3 patients were female, aged （69 ± 10） years and E-AAAs in 187 （81.3%） patients, 162 of which were male, the other 25 patients were female, aged （71 ± 9） years. Patients were followed up at 1 month after EVAR. The primary outcome of the study was perioperative mortality, secondary outcome included procedural data and major perioperative adverse events. Results At baseline, there were no differences in age, gender, American Society of Anesthesiologists classification score, and basic diseases. S-AAA patients had larger aneurysms on average （6. 00 （1.97） cm vs. 5.10 （1.7） cm, Z = 2. 51, P = 0. O1 ）. S-AAA patients had shorter preoperative hospitalization （5.00 （5.0） days vs. 7. 00 （4. 0 ） days, Z = 1.86, P = 0. 02 ）. No differences in the perioperative mortality, respectively, 0 and 1.1% （ P = 0. 66 ）. Technical success and clinical success were all 100% and the other procedure data was similar （ P 〉0. 05 ）. The occurrence of major adverse events, including mortality, within the 30-day after EVAR were similar between S-AAA and E-AAA patients （0 vs. 2. 1%, P = 0. 43 ）. Conclusions There is no difference in perioperative outcome between S-AAA and elective E-AAA patients treated by EVAR. More study is needed to compare the middle and long-outcome between S-AAAs and E-AAAs after EVAR.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2014年第5期342-345,共4页
Chinese Journal of Surgery
关键词
主动脉瘤
腹
血管假体植入
支架
治疗结果
Aortic aneurysm, abdominal
Blood vessel prosthesis implantation
Stent
Treatment outcome
