中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2015年
9期
696-699
,共4页
吴忠隐%熊江%贾森皓%段琛%李悦%卫任%陈峰%刘杰%刘小平
吳忠隱%熊江%賈森皓%段琛%李悅%衛任%陳峰%劉傑%劉小平
오충은%웅강%가삼호%단침%리열%위임%진봉%류걸%류소평
腹主动脉瘤%血管假体植入%血管外科手术%治疗结果
腹主動脈瘤%血管假體植入%血管外科手術%治療結果
복주동맥류%혈관가체식입%혈관외과수술%치료결과
Aortic aneurysm,abdominal%Blood vessel prosthesis implantation%Vascular surgical procedures%Treatment outcome
目的 比较破裂性腹主动脉瘤行腔内修复术(EVAR)与开放手术围手术期的疗效.方法 回顾性分析2006年1月至2013年1月解放军总医院血管外科符合纳入和排除标准接受手术治疗的66例破裂性腹主动脉瘤患者的临床资料,根据手术方式分为EVAR组(40例)和开放手术组(26例).EVAR组男性30例,女性10例;年龄47 ～ 78岁,平均年龄(71±7)岁.开放手术组男性21例,女性5例;年龄45 ～ 87岁,平均年龄(72±9)岁.采用x2检验和t检验比较2组患者围手术期手术时间、术中输血量、ICU时间、病死率、不良事件发生率及二次干预率的差异.结果 EVAR组手术时间、术中输注悬浮红细胞数量、ICU时间、病死率及不良事件发生率均低于开放手术组,组间差异均有统计学意义[(182 ±44) min比(384±108) min,t=-10.59,P=0.00;(0.4±0.8)单位比(1.1±1.8)单位,t=-2.19,P=0.03;(3.0±1.8)d比(8.5±5.1)d,t=-6.34,P=0.00;20.0％ (8/40)比46.2％ (12/26),x2 =5.10,P =0.02;25.0％ (10/40)比53.8％ (14/26),x2=5.67,P =0.02].2组术中输注冰冻血浆数量、二次干预率差异无统计学意义(分别为t=-1.98,P=0.05;x2=0.49,P=0.48).结论 EVAR较开放手术可降低破裂性腹主动脉瘤围手术期病死率和不良事件发生率,但中远期疗效尚需进一步研究.
目的 比較破裂性腹主動脈瘤行腔內脩複術(EVAR)與開放手術圍手術期的療效.方法 迴顧性分析2006年1月至2013年1月解放軍總醫院血管外科符閤納入和排除標準接受手術治療的66例破裂性腹主動脈瘤患者的臨床資料,根據手術方式分為EVAR組(40例)和開放手術組(26例).EVAR組男性30例,女性10例;年齡47 ～ 78歲,平均年齡(71±7)歲.開放手術組男性21例,女性5例;年齡45 ～ 87歲,平均年齡(72±9)歲.採用x2檢驗和t檢驗比較2組患者圍手術期手術時間、術中輸血量、ICU時間、病死率、不良事件髮生率及二次榦預率的差異.結果 EVAR組手術時間、術中輸註懸浮紅細胞數量、ICU時間、病死率及不良事件髮生率均低于開放手術組,組間差異均有統計學意義[(182 ±44) min比(384±108) min,t=-10.59,P=0.00;(0.4±0.8)單位比(1.1±1.8)單位,t=-2.19,P=0.03;(3.0±1.8)d比(8.5±5.1)d,t=-6.34,P=0.00;20.0％ (8/40)比46.2％ (12/26),x2 =5.10,P =0.02;25.0％ (10/40)比53.8％ (14/26),x2=5.67,P =0.02].2組術中輸註冰凍血漿數量、二次榦預率差異無統計學意義(分彆為t=-1.98,P=0.05;x2=0.49,P=0.48).結論 EVAR較開放手術可降低破裂性腹主動脈瘤圍手術期病死率和不良事件髮生率,但中遠期療效尚需進一步研究.
목적 비교파렬성복주동맥류행강내수복술(EVAR)여개방수술위수술기적료효.방법 회고성분석2006년1월지2013년1월해방군총의원혈관외과부합납입화배제표준접수수술치료적66례파렬성복주동맥류환자적림상자료,근거수술방식분위EVAR조(40례)화개방수술조(26례).EVAR조남성30례,녀성10례;년령47 ～ 78세,평균년령(71±7)세.개방수술조남성21례,녀성5례;년령45 ～ 87세,평균년령(72±9)세.채용x2검험화t검험비교2조환자위수술기수술시간、술중수혈량、ICU시간、병사솔、불량사건발생솔급이차간예솔적차이.결과 EVAR조수술시간、술중수주현부홍세포수량、ICU시간、병사솔급불량사건발생솔균저우개방수술조,조간차이균유통계학의의[(182 ±44) min비(384±108) min,t=-10.59,P=0.00;(0.4±0.8)단위비(1.1±1.8)단위,t=-2.19,P=0.03;(3.0±1.8)d비(8.5±5.1)d,t=-6.34,P=0.00;20.0％ (8/40)비46.2％ (12/26),x2 =5.10,P =0.02;25.0％ (10/40)비53.8％ (14/26),x2=5.67,P =0.02].2조술중수주빙동혈장수량、이차간예솔차이무통계학의의(분별위t=-1.98,P=0.05;x2=0.49,P=0.48).결론 EVAR교개방수술가강저파렬성복주동맥류위수술기병사솔화불량사건발생솔,단중원기료효상수진일보연구.
Objective To compare the perioperative outcome between the endovascular repair (EVAR) and open surgical repair (OSR) for ruptured abdominal aortic aneurysm.Methods From January 2006 to January 2013,totally 66 patients with ruptured abdominal aortic aneurysm (rAAA) treated by surgery were retrospectively analyzed in Department of vascular surgery,People's Liberation Army General Hospital.According to the repair method,all the subjects were divided into EVAR group and OSR group.EVAR group included 40 patients,30 patients were male,10 patients were female,aged from 47 to 78 with a mean of (71 ±7) years.OSR group included 26 patients,21 patients were male,aged from 45 to 87 with a mean of (72 ± 9) years.The difference of the operation time,the amount of suspended red blood cells,ICU stay time,case fatality rate,adverse event rate and the difference of the two intervention rate were compared between the 2 groups by x2 test and t test.Results There were significant differences between the 2 groups in operation time,the amount of suspended red blood cells,ICU stay time,case fatality rate,adverse event rate ((183 ±44) minutes vs.(384 ± 108) minutes,t =-10.59,P =0.00;(0.4 ±0.8)units vs.(1.1±1.8) units,t=-2.19,P=0.03;(3.0±1.8) dvs.(8.5±5.1) d,t=-6.34,P=0.00;20.0％ (8/40) vs.46.2％ (12/26),x2 =5.10,P =0.02;25.0％ (10/40) vs.53.8％ (14/26),x2 =5.67,P =0.02).There were no significant differences in frozen plasma quantities and the two intervention rate between the 2 groups (t =-1.98,P =0.05;x2 =0.49,P =0.48).Conclusions EVAR decreases the perioperative mortality and adverse event of rAAA compared with OSR.More studies are necessary to compare the middle and long-outcome between EVAR and OSR of rAAA.
