腹主动脉瘤血管腔内治疗与开放手术治疗的疗效比较

目的 比较腹主动脉瘤血管腔内治疗与开放手术治疗的近期疗效。方法 对34例肾下型腹主动脉瘤患者的临床资料进行分析，比较腔内治疗组（15例）与传统开放手术治疗组（19例）的术前状况、手术相关情况、术后并发症、死亡率及手术前后的实验室检查数据。结果 腔内组术中出血量和输血量明显少于手术组（P=0．005、P=0．015），腔内组术后平均禁食时间和平均住院时间较手术组明显缩短（P〈0．0l、P：0．001）。手术组术后并发症发生率明显高于腔内组（P〈0．01）。术后第3天白细胞计数腔内组明显低于手术组（P=0．020）；术后第5天红细胞计数及血肌酐水平在腔内组均明显高于手术组（P=0．011、P=0．034）。结论 腹主动脉瘤血管腔内治疗具有安全、微创、对人体内环境干扰小的优点，近期疗效较传统开放手术好。

Endovascular repair and open surgery for abdominal aortic aneurysm

Objective To compare the early result of endovascular repair and conventional open repair for abdominal aortic aneurysm. Methods We analyzed the clinical data of 34 patients with infrarenal AAA. Among them, 15 patients were treated with endovascular repair ( EVR group), 19 with conventional open repair ( COR group). Pre-operative status, intra-operative variables, post-operative outcomes and laboratory findings of the two groups were compared. Results Blood loss and blood transfusion in EVR group were significantly less than COR group (P =0.005, P =0.015). The median fasting period and post-operative hospital stay were shorter in EVR group (P <0. 01, P = 0. 001). Postoperative complications were more often in COR group (P <0. 01). WBC count in EVR group was lower in the third day post-operation (P =0. 020). RBC and serum Cr in EVR group were significantly higher in the fifth day after operation (P =0. 011, P =0. 034). Conclusion Endovascular repair of AAA is better for early results than conventional open repair and has the advantages of safety, less trauma and less disturbance to internal environment.