摘要
目的 验证腹主动脉瘤腔内修复术在中国人群的可行性。方法 前瞻性收集我院 1997年 9月～ 2 0 0 1年 10月间收治的 92例行择期手术的腹主动脉瘤患者 ,对其临床资料进行分析 ,比较腔内修复术治疗患者 (腔内组 ,n =31)与传统开腹手术治疗患者 (手术组 ,n =6 1)的术前状况、术中失血量、并发症、术后恢复时间及手术死亡率 ,并随访两组患者的并发症和生存率情况。结果 腔内组的年龄为 4 2～ 89岁 ,平均为 (70 .8± 10 .2 )岁 ;手术组的年龄为 30～ 82岁 ,平均为 (6 4 .5± 12 .9)岁 ,两组差异有显著性 (P =0 .0 14 )。腔内组患者合并冠心病、脑血管病的比例分别为 4 1.9%和 2 9.0 % ,手术组分别为 2 1.3%和 6 .6 % ,两组差异有显著性 (P =0 .0 38、0 .0 0 8)。两组腹主动脉瘤累及髂动脉、吸烟史等基线状况 ,以及合并慢性阻塞性肺气肿、肾功能不全、高血压、恶性肿瘤、动脉硬化闭塞症和糖尿病等疾病的差异均无显著性。腔内组术中失血量和输血量中位数分别为 30 0ml和 0ml,手术组分别为 10 0 0ml和 10 0 0ml,两组差异均有显著性 (P值均 <0 .0 0 1)。腔内组术后ICU观察时间和禁食时间的中位数分别为 0h和 2 4h ,手术组分别为 6 7h和 96h ,两组差异均有显著性 (P值均<0 .0 0 1)。两组的手术成功率。
Objective To investigate the feasibility of endovascular repair (EVR) of abdominal aortic aneurysm (AAA). Methods Between September 1997 and October 2001, 92 patients; 71 male, mean age (66.7±12.4) years (range 30～89 yrs) with AAA were treated with elective operation. Among them, 31 patients were treated with EVR, 61 with conventional open surgical repair (OSR). Data of the two groups were collected and compared previously with a follow up period ended in December 2001. Results There were 2 deaths with each in EVR group and OSR group during perioperative period. The median blood lost and blood transfusion was 300 ml and 0 ml in EVR group compared with 1 000 ml each in OSR group( P <0.001). The median observation period in ICU and fasting period were 0 h and 24 h in EVR group compared with 69 hr and 96 hr in the matched OSR group( P <0.001). And there was no immediate death in EVR group but 2 deaths in OSR group during follow up [mean (25.4 ±12.7) months, range 3.4～51.8 months]. The accumulative survival rate of EVR group was 93.55% compared to 81.85% of matched OSR group (log rank test, P =0.393). Conclusion EVR is also eligible for Chinese patients, some high risk patients can also tolerate well. EVR has the advantages of mild trauma, less blood loss and quicker recovery after operation.
出处
《上海医学》
CAS
CSCD
北大核心
2003年第8期537-540,共4页
Shanghai Medical Journal
基金
上海市卫生系统"百人计划"培养基金资助项目( 97BR0 2 8)
