Comparison the therapeutic effect of endovascular aneurysm repair and open repair for abdominal aortic aneurysm
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摘要:
目的:比较腹主动脉瘤（AAA）手术切除与腔内治疗的效果，探讨手术时机及治疗方式的选择。 方法:回顾性分析我院近4年多来进行手术治疗的51例肾下腹主动脉瘤患者的临床资料，比较传统手术切除组（37例）与腔内支架植入组（14例）围手术期及术后近期情况。 结果:支架组手术时间、重症监护时间均短于切除组（P<0.05），支架组术后住院天数明显短于切除组（P<0.01），但住院费用远较切除组高［（13.7±4.7)万元 vs. (3.4±0.7)万元］。术后近期并发症两组间差异无统计学意义。 结论:腔内支架治疗较为安全，创伤更小，患者恢复速度较快。但腔内治疗的费用目前仍过高，且远期疗效尚需大规模随机对照实验进行验证。
Abstract:
Abstract:Objective:To compare the therapeutic effect of endovascular repair(EVAR) and open surgical repair (OSR) of abdominal aortic aneurysm, and discuss how to select a proper time and method of operation. Methods :The clinical data of fifty-one patients with infrarenal abdominal aortic aneurysm who received surgical treatment in the recent four years were analyzed. The perioperative and short term advantages and disadvantages of OSR group (n=37) were compared with EVAR group (n=14). Results:Compared to OSR group, the EVAR group had shorter time of operation and intensive care(P<0.05), and shorter hospital stay after operation (P<0.01), but the cost of hospitalization was far higher than that of OSR group［(137 000±47 000) vs. (34 000±7 000)］.There was no statistically significant difference in short term postoperative complications between the two groups. Conclusions:EVAR is safer and less traumatic method than OSR, and patients can recover more rapidly. But the cost of hospitalization of EVAR remains too exorbitant.Large randomized controlled trial is necessary to validate the long term effects of EVAR.