关于老年人选择性腹腔大动脉动脉瘤修复的考虑因素
Mathijs J Biemond1, Jitse H M Paping1, Ruth M A Bulder1
1Dept. of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Annals of vascular surgery
|December 4, 2025
概括
老年人越来越多地接受腹腔大动脉动脉瘤 (AAA) 修复,八岁以上的人的风险更高. 建议对AAA修复设定特定年龄的门值,特别是对于77岁以上的女性而言,她们不符合内血管修复的条件.
科学领域:
- 血管外科 血管外科
- 流行病学 流行病学
- 老年医学 老年医学
背景情况:
- 腹腔大动脉动脉瘤 (AAA) 的流行病学显示,老年患者的修复趋势.
- 虽然晚年增加了手术风险,但它与AAA断裂的终身风险降低相关.
- 这项研究为有关老年人群中AAA修复的临床决策提供了必要的背景.
研究的目的:
- 分析AAA修复人口统计和人口老龄化结果的趋势.
- 评估患者年龄,手术风险和AAA修复后的存活率之间的关系.
- 为了为腹腔大动脉动脉瘤管理的特定年龄的干预策略提供信息.
主要方法:
- 使用了来自荷兰统计局的国家行政数据.
- 估计AAA修复患者年龄和性别分布的时间变化趋势.
- 评估年龄过程风险关系和修复后的生存率.
主要成果:
- 在1995年至2023年期间,AAA修复的平均年龄从69.9岁增加到73.9岁,八十岁的年龄增加了三倍,达到21.4%.
- 修复后的中位生存时间随着年龄的增长显著下降;80岁的人的生存时间比70岁的人要短得多.
- 开放性修复显示,在75岁以上的90天死亡风险增加,特别是在女性中,而内血管修复风险仍然较低,但在80岁后增加.
结论:
- 对AAA修复的特定年龄干预门是合理的.
- 对于77岁以上接受开放性修复的女性,如果不是内血管修复的候选人,应该考虑保守的管理.
- 考虑到年龄,性别和修复类型的量身定制的管理策略对于优化AAA治疗结果至关重要.
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