摘要
目的 比较局部麻醉经皮穿刺与股动脉切开实施急性胸主动脉综合征腔内修复术(TEVAR)的早期疗效,为手术入路股动脉处理方式选择提供依据.方法 选取北部战区总医院自2018年10月至2020年3月收治的行TEVAR治疗的236例急性胸主动脉综合征(ATAS)患者为研究对象.根据TEVAR中采用的股动脉处理方式,将其分为A组(n=120)与B组(n=116).A组采用股动脉切开,B组采用局部麻醉穿刺.记录并比较两组患者的一般资料、手术及住院资料、在院期间临床不良事件发生情况,以及随访结果.结果 A组患者的冠心病史比例高于B组,肌酸激酶同工酶低于B组,差异均有统计学意义(P<0.05).A组患者的手术时间、住院天数、除支架外住院医疗费用均明显高于B组,差异均有统计学意义(P<0.05).住院期间,A组患者新发急性肾功能衰竭发生率、伤口延期愈合发生率均明显高于B组,差异均有统计学意义(P<0.05).随访期间,两组患者全因死亡、新发脑卒中、伤口延期愈合、主动脉相关不良事件、总体不良事件发生率比较,差异均无统计学意义(P>0.05).结论 对于ATAS患者,经皮穿刺预缝合技术实施TEVAR安全可行,明显减少术后制动与住院时间,并降低医疗费用.
Objective To compare the early efficacy of local anesthesia percutaneous puncture and femoral arteriotomy for intracavitary repair of acute thoracic aortic syndrome(TEVAR),and to provide a basis for the selection of femoral artery treatment.Methods A total of 236 patients with acute thoracic aortic syndrome(ATAS)treated with TEVAR in General Hospital of Northern Theater Command from October 2018 to March 2020 were selected as the study subjects.According to the femoral artery treatment in TEVAR,they were divided into group A(n=120)and group B(n=116).Femoral artery incision was performed in group A and puncture under local anesthesia in group B.General data, surgical and hospitalization data, clinical adverse events during hospitalization, and follow-up results of patients in the two groups were recorded and compared.Results The proportion of coronary heart disease history in group A was higher than that in group B,and creatine kinase isoenzyme was lower than that in group B,with statistical significance(P<0.05).The operation time, hospitalization days and hospitalization expenses except stent in group A were significantly higher than those in group B,with statistical significance(P<0.05).While in hospital, the incidence of new acute renal failure and delayed wound healing in group A was significantly higher than that in group B,with statistical significance(P<0.05).During the follow-up period, there were no significant differences in the incidence of all-cause death, new stroke, delayed wound healing, aortic related adverse events and overall adverse events between two groups(P>0.05).Conclusion For ATAS patients, percutaneous puncture and presuture technique using TEVAR is safe and feasible, which significantly reduces postoperative braking and hospital stay, and reduces medical costs.
作者
周铁楠
刘轩泽
王效增
李智佳
孔德福
ZHOU Tian-nan;LIU Xuan-ze;WANG Xiao-zeng;LI Zhi-jia;KONG De-fu(Department of Cardiology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2021年第12期1291-1294,共4页
Clinical Journal of Medical Officers
基金
辽宁省“兴辽英才计划”资助项目(XLYC2008004)。
关键词
急性胸主动脉综合征
胸主动脉腔内修复术
穿刺
股动脉切开
Acute thoracic aortic syndrome
Thoracic endovascular aortic repair
Puncture
Femoral artery incision
