腹主动脉瘤腔内修复与开放手术疗效比较

目的 比较腹主动脉瘤开放手术和腔内治疗的效果.方法 对2002年1月至2007年7月收治的223例分别行开放手术和腔内修复的腹主动脉瘤患者进行网顾性分析.手术组141例,男性118例,女性23例;腔内治疗组82例,男性66例,女性16例.对手术相关情况、围手术期并发症发生率、病死率、随访中并发症发生率等进行对比分析.结果 腔内修复组手术时间、术中出血量、输血量均少于开放手术组(P<0.01),围手术期并发症两组无显著差异(P>0.05),SF-36量表评估显示术后6个月开放手术组优于腔内治疗组,术后2年生存率两组无明显差异(P>0.05),但腔内修复组并发症发生率高于开放手术组(P<0.01).住院费用腔内修复组明显高于开放手术组(P<0.01).结论 腹主动脉瘤腔内修复具有手术时间短、微创的特点,但具有较高的远期并发症,开放手术组6个月健康生存质量优于腔内修复组.

Comparison of open and endovascular repair for abdominal aortic aneurysm

Objective To compare the effects of open and endovascular repair for abdominal aortic aneurysm. Methods From January 2002 to July 2007, clinical data of 223 patients with infrarenal abodomianl aortic aneurysm undergoing open (141 patients) or endovascular repair (82 patients) were retrospectively reviewed. The intra- and post-operative complications, mortality, complications, survival, life quality, and cost during follow-up were analyzed. Results Operative time in endovascular group was significantly shorter than open repair group. Blood loss and transfusion in endovascular group were significantly less than open repair group (P<0.01). There was no significant difference of intra- and post-operation complications (P>0.05). Six-month total SF-36 scores were significantly higher in open repair group compared with endovascular group. There was no significant difference of survival rate at 2 years (P>0.05), but endovascular group had fewer complications (P<0.01). Conclusions Endovascular repair is mini-invasive, but has more complications of long-term follow-up. The life quality in open repair group is better than endovascular group, and a prospective random trial is required.