老年腹主动脉瘤非手术治疗的长期超声随访研究

目的超声随访观察经非手术治疗的老年腹主动脉瘤的发展变化规律。方法超声随访诊断明确、病历及影像学资料完整的老年腹主动脉瘤非手术治疗患者37例，按首次发现时瘤体大小分3组，定期测量并记录各组腹主动脉扩张最明显处横切面直径，计算年增长量。结果37例腹主动脉瘤首次发现时瘤径大小平均为4．68cm，随访年限0．5～11年，平均6．1年，瘤径平均每年增长0．47cm。14例瘤径小于4．0cm，平均年增长0．23cm，15例瘤径小于6．0cm，平均年增长0．37cm，8例瘤径大于6．0cm，平均年增长0．67cm。随访期间死亡5例，其中因动脉瘤破裂死亡2例，破裂前瘤径大小分别为8．35cm、8．91cm。7例随访期间因瘤径短期内明显增大而行腹主动脉瘤腔内支架隔绝术。结论老年腹主动脉瘤瘤径小于6．0cm者随增龄增长缓慢，大于6．0cm者随增龄增长快，应进行积极的外科干预。

A long term follow-up study on the nonsurgical therapy of abdominal aortic aneurysm in senile patients

Objective To study the course of development of aneurysm of abdominal aorta (AAA) with nonsurgical treatment in senile patients. Methods 37 subjects were included in the study, and they were divided into 3 groups according to the size of aneurysm observed at the first visit. The diameter of aneurysm was measured, and the measurement was repeated at periodic follow up. The yearly increase of the diameter was calculated and analyzed. Results For the 37 patients, the AAA mean diameter was 4.68cm at the first visit. The period of follow-up was 0.5 to 11 years, with a mean of 6.1 years. The average yearly increase in tumor diameter was 0.47cm/year. 14 patients with aneurysm diameter of <4.0cm exhibited an average increase of 0.23 cm/year, while in 15 patients with the aneurysm diameter <6.0cm showed an average increase of 0.37cm/year. The remaining 8 patients with diameter of AAA >6.0cm had an average increase of 0.67cm/year. 5 patients died during the follow-up period, 2 of them died of rupture of the aneurysm, the diameter of which was 8.35cm and 8.91cm, respectively. Endoaneurysmorrhaphy with stent was performed in 7 patients. Conclusion The size of AAA in the senile patients increased slowly if the aneurysm diameter is <6.0cm. However, if the aneurysm diameter >6.0 cm, the tumor size might increase quickly, and active intervention is recommended.