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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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血管内静脉支架移植与患有下大动脉动脉瘤的患者的开放性手术:根据倾向评分进行调整的分析.

Harald Teufelsbauer1, Alexander M Prusa, Klaus Wolff

  • 1Department of Vascular Surgery, University of Vienna-Medical School, Vienna, Austria. alexanderprusa@hotmail.com

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概括

跨末内血管动脉瘤管理 (TEAM) 是高风险患者腹腔大动脉瘤 (AAA) 的一个不那么侵入性的选择. TEAM提供了可接受的死亡率和生存率,使得那些有重大并发症的人能够接受治疗.

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科学领域:

  • 血管外科 血管外科
  • 血管内干预 血管内干预
  • 患者风险分层患者风险分层

背景情况:

  • 跨末内血管动脉瘤管理 (TEAM) 越来越多地用于下腹腔大动脉瘤 (AAA).
  • 开放的移植移植仍然是AAA的标准护理.
  • 需要在高风险患者中为TEAM提供明确的指示.

研究的目的:

  • 为了在具有重大并发病症的患者中确定TEAM的明确指示.
  • 在AAA患者中比较TEAM和开放手术之间的死亡率.
  • 评估治疗方式对生存的影响.

主要方法:

  • 基于454名连续AAA患者 (1995-2000) 的倾向评分分析.
  • 医院住院死亡率 (MR) 的比较.
  • 考克斯比例危险模型 (COX) 用于对风险因素进行调整的900天生存估计 (SE).

主要成果:

  • TEAM患者的术前风险因素显著增加.
  • 在美国麻醉学会IV类患者中,TEAM的死亡率较低 (4.7%) 与开放手术 (19.2%) 相比.
  • 脏/肺功能受损,年龄增加和治疗选择预测的生存率.

结论:

  • 在具有显著风险因素的患者中,TEAM是AAA的不那么侵入性治疗方法.
  • 在老年患者中,TEAM提供了可接受的MR和SE,这些患者患有多种疾病.
  • TEAM使得AAA患者的治疗成为可能,否则他们可能无法治愈.