腔内修复术治疗腹主动脉瘤中远期疗效观察与探讨

目的 探讨腹主动脉瘤腔内修复术的中远期疗效.方法 2000年3月-2004年11月,行腔内修复术治疗腹主动脉瘤21例.男18例,女3例,年龄34～81岁,平均(66.2±7.3)岁.随访36～92个月,平均(56.0±10.2)个月,每个病例均填写标准化CRF表格,建立数据库,分析其临床特点及治疗效果.结果 术中内漏3例,右肾动脉栓塞1例,术后发生急性肾衰竭2例,急性左心衰1例,脑出血1 例,术后30天内死亡2例,死于多器官功能衰竭、呼吸循环衰竭.随访期间内漏2例,死亡2例,分别死于腹主动脉瘤破裂和膀胱癌肝转移.结论 腹主动脉瘤腔内修复术创伤小,恢复快,中远期严重并发症少,对于不能耐受传统外科手术的患者应优先选择腔内修复术.

The curative effect of endovascular abdominalaortic aneurysm repair and middle-long term follow-up

Objective To evaluate the curative effect of endovascular abdominalaortic aneurysm repair. Methods From Mar 2000 to Nov 2004, 21 patients with abdominalaortic aneurysm received endovascular repair. There were 18 males and 3 females with average age of (66.2±7.3) years (34-81 years). Patients were followed from 36 to 92 months, average (56.0±10.2) months. The clinical data of the patints were analyzed. Results During the operation, there were endoleaks in 3 cases, renal artery embolism in 1, after operation, acute renal failure in 2, acute left heart failure in 1, cerebral hemorrhage in 1. Two patients died within 30 days after operation because of multiple organ failure; 30-day mortality was 9.5%. Two patients died during follow-up time. Mortality during follow-up period was 10.5%. Conclusion Endovascular abdominalaortic aneurysm repair is feasible with less trauma, quick recovery and less complications and may be offered as the best means of therapy in some patients, especially in patients at high risk for traditional surgery.