2012年至2021年法国腹腔大动脉瘤管理趋势 从法国全国数据库:治疗方法和结果
Thomas Mesnard1,2, Antoine Guery1, Xavier Lenne3,4
1Service de chirurgie vasculaire, Centre de l'Aorte, CHU Lille, Lille, France.
World journal of surgery
|March 1, 2026
概括
在法国,腹腔大动脉动脉瘤 (AAA) 的内血管动脉瘤修复 (EVAR) 增加,死亡率低于开放大动脉手术 (OAR). 较高的体积中心和EVAR使用与更好的结果相关.
科学领域:
- 血管外科 血管外科
- 医疗健康数据分析
- 公共卫生 公共卫生
背景情况:
- 腹腔大动脉瘤 (AAA) 管理趋势和结果对公共卫生至关重要.
- 分析国家卫生数据,可以了解外科手术实践的演变.
研究的目的:
- 分析法国腹腔大动脉动脉瘤 (AAA) 手术治疗的最新趋势.
- 评估与内血管动脉瘤修复 (EVAR) 与开放性大动脉手术 (OAR) 相关的早期结果.
主要方法:
- 2012-2021年法国国家健康数据系统 (SNDS) 的回顾性分析.
- 包括完整的 (iAAA) 和破裂的 (rAAA) 病例,用EVAR或OAR治疗.
- 利用修改后的Elixhauser评分来评估并发症,并分析了住院死亡率和整体存活率.
主要成果:
- 对于iAAA和rAAA,EVAR的使用显著增加,而30天死亡率整体保持稳定.
- 与OAR相比,EVAR在iAAA (1.3%对4.1%) 和rAAA (18.7%对35.5%) 的30天死亡率都较低.
- 较高的Elixhauser分数,年龄≥80,女性性别预测了住院死亡率;较高的中心体积与较低的死亡率有关.
结论:
- 在法国,用于AAA治疗的EVAR的采用量大幅增加.
- 患者的并发病,年龄和性别显著影响术后死亡率.
- 将AAA治疗集中到大量治疗中心可能会改善患者的治疗结果.
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