摘要
目的探讨腹主动脉瘤腔内修复术中进行移植物旁瘤腔栓塞预防Ⅱ型内瘘的可行性和有效性。方法采取前瞻性的方法选取2016年6月至2018年6月华中科技大学同济医学院附属同济医院收治的行腹主动脉瘤腔内修复术的90例腹主动脉瘤患者,采取随机数字表法将患者分为对照组与观察组,每组各45例。对照组患者仅给予腹主动脉瘤腔内修复术治疗,观察组患者在对照组基础上实施术中移植物旁瘤腔栓塞治疗。比较两组患者围手术期并发症发生率,以及术后随访3个月、6个月、12个月Ⅱ型内瘘发生率。结果观察组围手术期的肾动脉覆盖、弹簧圈异位栓塞、动脉瘤破裂、血压异常升高发生率分别为0、0、0、4.44%,对照组围手术期的肾动脉覆盖、动脉瘤破裂、血压异常升高发生率分别为0、0、2.22%,两组患者围手术期的肾动脉覆盖、动脉瘤破裂、血压异常升高的发生率比较,差异均无统计学意义(P>0.05)。观察组随访3个月、随访6个月、随访12个月Ⅱ型内瘘发生率分别为0、2.22%、4.44%,对照组随访3个月、随访6个月、随访12个月Ⅱ型内瘘发生率分别为0、11.11%、27.78%,两组患者随访3个月的Ⅱ型内瘘发生率比较,差异无统计学意义(P>0.05)。随访6个月、12个月,观察组与对照组相比,Ⅱ型内瘘发生率较低,组间比较差异具有统计学意义(P<0.05)。结论腹主动脉瘤腔内修复术中进行移植物旁瘤腔栓塞预防Ⅱ型内瘘的效果显著,Ⅱ型内瘘发生率较低,并未增加围手术期并发症发生率,安全性有保障。
Objective To investigate and analyze the feasibility and effectiveness of graft embolization in the treatment of type II internal hemorrhoids during endovascular repair of abdominal aortic aneurysm.Methods A prospective method was used to select 90 patients with abdominal aortic aneurysm who underwent intraluminal repair of abdominal aortic aneurysm from June 2016 to June 2018 in Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,The patients were divided into Control group and observation group randomly,45 cases in each group.The control group was only treated with endovascular repair of abdominal aortic aneurysm,the observation group was treated with intraoperative graft embolization on the basis of the treatment method of the control group.The incidence of perioperative complications and the incidence of typeⅡinternal fistula at 3,6,and 12 months of follow-up were compared between the two groups.Results Perioperative renal artery coverage,ectopic embolization of coils,aneurysm rupture,and abnormally elevated blood pressure in the observation group were 0,0,0,and 4.44%in the perioperative period.Renal artery coverage,aneurysm rupture,and abnormally elevated blood pressure in the control group were 0,0,2.22%,respectively.Perioperative renal artery coverage,aneurysm rupture and abnormally elevated blood pressure in the two groups had no significant difference(P>0.05).The incidence of typeⅡfistula in the observation group were 0,2.22%,and 4.44%at 3 months,6 months and 12 months after treatment,respectively.And those in the control group were 0,11.11%and 27.78%,respectively.There was no significant difference in the incidence of typeⅡinternal fistula between the two groups after 3 months follow-up(P>0.05).Compared with the control group,the incidence of typeⅡinternal fistula at 6 months and 12 months was lower in the observation group with statistically significant difference(P<0.05).Conclusion The effect of prevention of typeⅡinternal fistula by side graft allograft in the intraluminal repair of abdominal aortic aneurysm is significant,the incidence of typeⅡinternal fistula is low,and the perioperative complications are not increased,and the safety is guaranteed.
作者
周雁荣
潘友民
郑智
查正彪
ZHOU Yan-rong;PAN You-min;ZHENG Zhi(Department of Cardiovascular Surgery,Tongji Hospital Tongji Medical Collegeof Huazhong University of Science and Technology,Wuhan Hubei 430030,China)
出处
《临床和实验医学杂志》
2020年第14期1525-1528,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省科技厅自然科学基金项目(编号:2015CFB072)。
关键词
腹主动脉瘤
腔内修复术
移植物旁瘤腔栓塞
Ⅱ型内瘘
并发症
Abdominal aortic aneurysm
Endovascular repair
Graft embolization of the tumor
TypeⅡinternal hemorrhoid
Complications
