腔内修复术与开放手术治疗腹主动脉瘤的对比分析

目的 对比分析传统开放手术与血管腔内修复术治疗腹主动脉瘤的疗效.方法 回顾性分析我科2009年至2012年经外科治疗的43例肾动脉下腹主动脉瘤患者的临床资料,行腔内治疗患者25例,行传统手术的18例,对比分析两组患者术前、术中情况,术后并发症及6个月内死亡情况.结果 两组患者在手术时间、术中失血及输血量方面,两组差异均有统计学意义（t值分别为8.377,5.124,5.043,P均＜0.001）;术后30d内并发症比较,差异有统计学意义（X2=0.09,P＜0.05）;术后6个月内死亡率比较,差异无统计学意义（x2=4.21,P＞0.05）.结论 血管腔内修复术比传统手术创伤小,手术时间短,术中失血及输血量少,术后短期并发症发生率低,但中远期死亡率无明显差别.

Comparative analysis of endovascular aneurysm repair and open operation in the treatment of abdominal aortic aneurysm

Objective To compare the efficacy of traditional open surgery and endovascular an- eurysm repair（EVAR） in the treatment of abdominal aortic aneurysm. Methods The clinical data of 43 surgical cases of infrarenal abdominal aortic aneurysm patients from 2009 to 2012 were retrospectively ana- lysed,including 25 cases of endovascular therapy and 18 cases of traditional open surgery. Preoperative and intraoperative conditions, postoperative complications and death within 6 months were compared between groups. Results There were significant differences in operation time, blood loss and blood transfusion be- tween the groups（ t = 8.3＂77,5. 124,5. 043, respectively, P 〈 O. 001 ）. There was significant difference in complication within 30 days between the groups （ X2 = 0.09, P 〈 0.05 ）. There was no significant difference in mortality rate within 6 months between the groups （ X2 = 4.21, P 〉 0.05 ）. Conclusion Endovascular aortic repair of abdominal aortic aneurysm has advantages in minimally invasion, short operative time, few intraoperative blood loss and transfusion,low postoperative complication rate in short-term. However, there is no significant difference in long-term mortality rate.