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目的探讨支架型人工血管介入治疗降主动脉假性动脉瘤的可行性及疗效。方法2001年9月至2004年12月,行支架型人工血管治疗降主动脉假性动脉瘤8例,其中男性7例,女性1例,年龄22~65岁,平均(45.4±15.1)岁。病因4例为外伤,1例为动脉硬化,3例病因不明。瘤体直径(3.9±1.3)cm。4例为急诊手术,4例择期手术。结果6例采用全身麻醉,2例采用硬膜外麻醉。支架型人工血管均顺利植入。术后30d内无死亡。1例有近端内漏。术后脑梗塞1例。术后随诊2~30个月,平均(9.3±10.7)个月,术后4个月死亡1例,病因为内漏导至动脉瘤破裂。1例于5个月后因再发假性动脉瘤,接受再次支架型血管植入术,于2次手术后2个月死亡。随诊死亡2例,死亡率25%。结论支架型人工血管是治疗主动脉假性动脉瘤的有效方法,中远期效果还有待进一步观察。
Objective To investigate the feasibility and efficacy of scaffold-based vascular interventional therapy for descending aortic pseudoaneurysm. Methods From September 2001 to December 2004, 8 cases of descending aortic pseudoaneurysm were treated with scaffold prosthesis. There were 7 males and 1 females, aged from 22 to 65 years with an average of 45.4 ± 15.1 years. The cause was trauma in 4 cases, arteriosclerosis in 1 case, and etiology in 3 cases. Tumor diameter (3.9 ± 1.3) cm. 4 cases of emergency surgery, 4 cases of elective surgery. Results Six cases received general anesthesia and two cases received epidural anesthesia. Stent-type artificial blood vessels are successfully implanted. No death within 30 days after operation. 1 case of proximal endoleak. Postoperative cerebral infarction in 1 case. The patients were followed up for 2 to 30 months, with an average of (9.3 ± 10.7) months and 1 patient died after 4 months. The cause was internal leakage leading to aneurysm rupture. One patient died of reappearance of pseudoaneurysm 5 months later undergoing stent-graft surgery and died 2 months after 2 surgeries. Follow-up death in 2 cases, the mortality rate of 25%. Conclusion Stent-type vascular prosthesis is an effective method for the treatment of aortic pseudoaneurysm. The long-term effect remains to be further observed.