腔内修复术治疗中高危腹主动脉瘤的临床疗效评价

Clinical efficacy of traditional open repair surgery and endovascular aneurysm repair in treatment of abdominal aortic aneurysm with middle or high risk

摘要:

摘要：目的  探讨腔内修复术治疗中、高危腹主动脉瘤（AAA）患者的疗效优势。方法  回顾性收集该院2012年3月-2015年5月AAA患者共62例。根据手术方式不同，分为开腹手术（OSR）组29例和腔内修复手术（EVAR）组33例，比较两组患者术前临床资料、手术相关变量和术后恢复情况。结果  两组患者术前资料基本一致，具有可比性（P >0.05）。在手术治疗方面，EVAR组术中输血量和失血量低于OSR组，差异有统计学意义（P <0.05）；EVSR组患者较少采用全身麻醉方式，两组比较差异有统计学意义（P <0.05）；两组手术费用比较，差异有统计学意义（P <0.05），EVSR组高于OSR组。在随访方面两组比较差异有统计学意义（P <0.05），EVSR组术后手术相关并发症发生率高于OSR组患者。两组患者在术后死亡率、非手术相关并发症的比较，差异无统计学意义（P >0.05）。结论  EVSR治疗中、高危AAA患者近期手术疗效优于OSR，有助于中、高危AAA患者的微创治疗，但其远期疗效优势尚需进一步论证。

关键词:

腹主动脉瘤;腔内修复术;传统开腹术;疗效;中-高危

Abstract:

Abstract: Objective To study the advantage of efficacy of endovascular aneurysm repair in the treatment of abdominal aortic aneurysm with middle or high risk. Methods A total of 62 patients who were admitted into our hospital from March 2012 to May 2015 were enrolled and divided into traditional open repair surgery group (OSR group, 29 cases) and endovascular aneurysm repair group (EVAR group, 33 cases) according to the type of operation. Preoperative demographic characteristics, variables related to the operation and the condition of postoperative recovery were compared between the two groups. Results The preoperative data of the patients in the two groups were consistent and comparable (P > 0.05). In surgical treatment, the amount of intraoperative blood transfusion and intraoperative blood loss of the EVAR group were significantly smaller than that of the OSR group (P < 0.05). Compared with the OSR group, fewer patients received general anesthesia in the EVAR group, demonstrating statistically significant difference (P < 0.05). The costs of the EVSR patients were significantly higher than those of the OSR group, demonstrates statistically difference (P < 0.05). In the process of follow-up, the rates of postoperative complications related to the operation in the EVAR group were significantly higher than those in the the OSR group (P < 0.05). The postoperative mortality and the rates of other major complications were similar between these two group (P > 0.05). Conclusions The short-term surgical effect of the EVAR for the middle or high risk abdominal aortic aneurysm patients is superior to that of traditional open surgery. EVAR may be helpful to the minimally invasive treatments for these patients, but the long-term curative effect remains to be further investigated.

Key words:

abdominal aortic aneurysm; traditional open surgery group; endovascular aneurysm repair; efficacy; middle or high risk