主-髂动脉支架感染保守治疗的临床分析

目的探讨保守治疗主-髂动脉腔内修复术后血管内支架感染(EGI)的安全性及临床疗效。方法回顾性分析5例主-髂动脉瘤或主-髂动脉假性动脉瘤腔内修复术后发生EGI的患者资料。对5例EGI患者均行保守治疗,给予21~42天敏感抗生素静脉滴注,出院后继续口服抗生素60天。并对患者进行随访。结果 5例患者经保守治疗后发热及腹痛症状均明显好转,未发生EGI相关并发症,住院时间32~66天,中位住院时间42天。出院前1周内复查血白细胞计数、血液细菌培养及CTA均未见异常。出院后随访16~78个月,中位随访时间50个月,随访期间均无EGI复发,血常规、血液细菌培养均无阳性发现,CTA检查未见EGI相关征象。结论对不适合外科手术的主-髂动脉EGI患者,保守治疗也可获得较为满意的疗效。

Conservative treatment of graft infection after endovascular repair of aortoiliac aneurysm

Objective To investigate the safety and clinical efficacy of conservative treatment of endovascular graft infection (EGI) in aorto-iliac artery after endovascular repair. Methods The data of 5 patients with EGI caused by primary aortoiliac aneurysms or aortoiliac pseudoaneurysm after endovascular repair were retrospectively analyzed. All patients were treated by conservative treatment of intravenous dripping antibiotics regimen for 21-42 days, and prolonged for another 60 days after discharge. And the follow-up was performed. Results After conservative treatment, the body temperature returned to normal in all patients. And the abdominal pain were eased. No complication related to EGI occurred. The hospital stay time ranged from 32 to 66 days (median 42 days). The results of blood routine test, blood cultures test and the CTA were normal at 1 week before the discharge. The follow-up range was 16-78 months (median 50 months). During the follow up, no relapsing symptoms related to EGI were found. The results of blood routine test were normal and blood culture test were negative. The CTA showed no signs of EGI. Conclusion The conservative treatment can also obtain a satisfactory curative effect in aorto-iliac artery EGI patients who are not suitable for surgical treatment.