手术治疗腹主动脉瘤205例远期疗效分析

目的评价手术治疗肾下型腹主动脉瘤的围手术期和远期效果。方法回顾性分析205例肾下型腹主动脉瘤切除术的临床资料,总结围手术期并发症和远期生存率,评价手术治疗腹主动脉瘤的安全性和远期疗效。结果30 d围手术期死亡率为1．0％;手术时间3-6 h,平均(3．8±1．4)h;ICU恢复时间中位数为16 h。围术期主要并发症包括心功能不全18例,呼吸功能不全10例,急性心肌梗塞2例,急性脑梗塞2例,急性肾功能衰竭4例;寿命表分析1、3、5年生存率分别为96．2％,83．1％,75．8％,随访中未发现与人工血管移植有关的死亡病例和并发症。结论手术仍是腹主动脉瘤的标准治疗方法。术前全身系统风险的评估和围手术期的谨慎管理在提高手术治疗效果中起重要作用。

Long-term results of abdominal aortic aneurysm in 205 patients undergoing open graft replacement

Objective To evaluate perioperative and long-term outcomes in patients with infrarenal abdominal aortic aneurysms who were treated by open repair. Methods Clinical data of 205 patients with infrarenal abdominal aortic aneurysm undergoing elective open repair were retrospectively reviewed. Perioperative complications and long-term survival were evaluated. Results Thirty day surgical mortality was 1. 0%. The surgery varied from 3 to 6 hours, with a mean of 3. 6 hours. Median length of ICU stay was 16 hours. Major perioperative complications included heart insufficiency in 18 patients, pulmonary insufficiency in 10 patients, acute myocardial infarction in 2 patients. Two patients developed cerebral infarction, 4 patients suffered from acute renal failure. Life-table estimates for 1,3,5-year survival rate were 96.2%, 83. 1% and 75.8% respectively, during the period no graft-related mortality or morbidity was identified. Conclusion Open infrarenal abdominal aortic aneurysm repair is safe and tolerable for the majority of patients. Systematic risk assessments and careful perioperative management play important roles in improving results of open repair.