摘要目的 比较分析开放手术与腔内修复术在累及内脏动脉腹主动脉瘤中的应用价值.方法 搜集北京协和医院2012年1月至2016年10月收治的26例累及内脏动脉分支的腹主动脉瘤患者,根据其治疗方式分为开放手术组(n=7)和腔内修复组(n=19),对两组患者相关资料及随访数据进行总结分析.结果 开放手术组7例均为男性患者,中位年龄为58(41 ～62)岁,其中75岁以上1例;腔内修复组共19例患者,14例为男性,中位年龄为72(66 ～76)岁,75岁以上8例,腔内修复组患者年龄明显高于开放手术组(Z=-13.06,P＜0.05).两组术后并发症的发生率分别为57.14％和15.79％,但因样本数较少,差异无统计学意义(x2=3.13,P＞0.05).行支架隔绝术者,术后随访其瘤体直径较前均有不同程度缩小.结论 在累及内脏动脉分支的腹主动脉瘤的治疗中,开放手术主要适用于低风险的患者群,但其术后并发症的发生率较高.而腔内修复术的创伤小、安全性较高,已逐渐成为首选的治疗方法.

abstractsObjective To evaluate the value of open surgery repair and endovascular aortic repair in the treatment of abdominal aortic aneurysm which implicate visceral arteries.Methods From January 2012 to October 2016,26 patients were reviewed.According to the treatment,they were divided into open surgery group (n =7) and endovascular repair group(n=19).Then,the characteristics and relative data of follow-up of the two groups were analysis.Results In open surgery group,there were 7 patients.All of them were men,median age 58(41-62) years and 1 patient were older than 75 years.And in endovascular repair group,there were 19 patients(14 men) of median age 72 (66-76) years,8 patients were older than 75 years.Patients in endovascular repair group were significantly older than who were in open surgery group (Z =-13.06,P ＜ 0.05).Complications of open surgery group and endovascular repair group were 57.14％ and 15.79％ respectively.There was no statistically significant difference (x2 =3.13,P ＞ 0.05).During follow-up,the diameters of aneurysm which planted stents were smaller than before.Conclusions In the treatment of abdominal aortic aneurysm implicated visceral arteries,open surgery is mainly suitable for the patients with low-risk.But the rate of complications was high.By contrast,endovascular aortic repair with small trauma and high safety,has becoming the first choice.