破裂腹腔大动脉动脉瘤患者的治疗结果
Hyangkyoung Kim1, Tae-Won Kwon2, Yong-Pil Cho3
1Department of Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
Journal of Korean medical science
|October 11, 2023
概括
与开放式手术修复 (OSR) 相比,对破裂腹腔大动脉动脉瘤 (rAAA) 的内血管动脉瘤修复 (EVAR) 显示出更好的短期结果,但较差的长期结果. 患者的选择应平衡术后风险与长期生存前景.
科学领域:
- 血管外科 血管外科
- 大动脉动脉瘤研究研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 破裂腹腔大动脉动脉瘤 (rAAA) 具有显著的死亡和发病风险.
- 在国家患者队列中评估治疗结果对于临床决策至关重要.
研究的目的:
- 为了比较韩国患者对rAAA的内血管动脉瘤修复 (EVAR) 与开放式手术修复 (OSR) 的外科和长期结果.
- 根据国家医疗保险数据分析生存率,再干预和并发症.
主要方法:
- 对国家医疗保险服务 (NHIS) 数据库 (2009-2018) 的回顾性分析.
- 包括接受rAAA的EVAR或OSR的患者.
- 评估术后期 (≤30天),早期术后期 (≤3个月) 和长期 (>3个月) 的结果.
主要成果:
- 确诊了1034名rAAA患者,594名EVAR,440名OSR.
- EVAR组的术后死亡率较低 (29.8%与35.0%相比,P=0.028).
- 在OSR组,与腹腔大动脉动脉瘤相关的再干预率明显较低 (aHR,0.31;P=0.005),而长期全因死亡率没有显著差异.
结论:
- 对于rAAA,EVAR表现出卓越的术后结果.
- 与OSR相比,EVAR的长期结果 (>3个月) 显着更差.
- 对rAAA的治疗决定应权衡术后风险与长期生存益处,考虑解剖学可行性.
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