腹主动脉瘤开放手术和腔内修复术围术期情况回顾分析

目的分析比较腹主动脉瘤(AAA)患者行开放手术治疗及腔内修复术治疗的围术期情况。方法选择2010年6月至2012年6月首都医科大学附属北京安贞医院血管外科住院治疗的AAA患者79例,其中行开放手术者35例(手术组),行腔内修复术者44例(支架组)。统计分析2组患者的手术时间、术中出血量、输血量、术后拔管时间、监护室停留时间及并发症发生情况等。结果手术组患者手术时间较支架组长,术中出血量及输血量较支架组大,其差异均有统计学意义(P<0.05)。结论开放手术和腔内修复术治疗AAA均安全有效。腔内修复术具有手术时间短、出血量及输血量少、围术期并发症较少等优势。对于高龄及术前并发症较多的高危患者,可采用腔内修复术,围术期加强监护,以减少或避免并发症的发生。

Comparison of perioperative events between open repair and endovascular repair in abdominal aortic aneurysm patients

Objective To analyze and compare the perioperative events of open repair and endovascular repair in abdominal aortic aneurysm(AAA)patients.Methods A total of 79 patients with AAA in Department of Vascular Surgery,Beijing Anzhen Hospital Affiliated to Capital University of Medical Science from June 2010 to June 2012 were selected,including 35 cases of open repair as surgery group and 44 cases of endovascular repair as stent group.The perioperative events of the 79 cases were kept statistics and analyzed,including operative time,intraoperative hemorrhage,blood transfusion,extubation time,stay time in intensive care unit,and complications,etc.Results Compared with stent group,the operative time of surgery group was longer,and the intraoperative hemorrhage and blood transfusion were much more,the differences had statistical significance(P<0.05).Conclusion Both open repair and endovascular repair are safe and effective to AAA.As minimally invasive surgery,endovascular repair has the advantages of shorter operative time,less intraoperative hemorrhage and blood transfusion,and less perioperative complications.For the high-risk patients who had advanced age or multi-complication,it is much more important to strengthen supervision,give actively and positively,in order to decrease or avoid complications.