中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (12): 1104-1106.

• 论著 • 上一篇    下一篇

炎性腹主动脉瘤与动脉硬化性腹主动脉瘤临床特点及远期疗效对照研究

王少也，张    健，尹鸣镝，王    永，段志泉，辛世杰   

  1. 中国医科大学附属第一医院普通外科教研室 血管外科，辽宁沈阳110001
  • 出版日期:2011-12-01 发布日期:2011-11-28

  • Online:2011-12-01 Published:2011-11-28

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摘要：

目的    总结炎性腹主动脉瘤（inflammatory abdominal aortic aneurysm，iAAA）的临床特点，探讨其远期疗效。方法    回顾性分析中国医科大学第一医院1988-2008年间412例腹主动脉瘤（AAA）病人中择期手术的11例iAAA（2.7%）的临床资料，并选择与11例iAAA病人年龄、性别及术前危险因素等相匹配的 33例动脉硬化性腹主动脉瘤（aAAA）病人进行病例对照研究。结果    iAAA病人与aAAA病人相比，临床症状明显（100% vs. 42.4%，P=0.001）、瘤体直径显著增大［（7.4±0.7）cm  vs.（6.3±0.9）cm，P=0.006］、术前的红细胞沉降率明显升高［（44.5±9.1）mm/h vs. （11.4±5.4）mm/h，P<0.05］。两组病例的手术并发症发生率和病死率的差异无统计学意义。在手术时间方面，iAAA病人明显要长于aAAA病人［（308±36）min vs.（224±46）min，P<0.05］，但腹主动脉阻断时间两组基本相同［（41.5±6.2）min vs.（41.8±6.2）min，P= 0.92］。两组病人5年存活率的差异无统计学意义（P=0.711）。结论    临床诊治过程中iAAA面临诸多挑战，但iAAA仍可以按aAAA一样处理，其远期治疗结果与aAAA基本相同。

关键词: 炎性腹主动脉瘤, 动脉硬化性腹主动脉瘤

Abstract:

Case-control study on clinical features and long term effect of inflammatory abdominal aortic aneurysm in comparison with atherosclerotic abdominal aortic aneurysm        WANG Shao-ye, ZHANG Jian, YIN Ming-di, et al. Department of Vascular Surgery, the First Hospital, China Medical University, Shenyang 110001, China
Corresponding author: ZHANG Jian, E-mail: jianzhang_cmu@yahoo.com.cn
Abstract    Objective    To analyze clinical features and long term effect of inflammatory abdominal aortic aneurysm (iAAA). Methods    Between 1988 and 2008, 412 cases of AAA in the First Hospital of China Medical University were performed elective surgical operations. Eleven (2.7%) of them were diagnosed as iAAA. The former group was matched in a case control fashion to a group of 33 patients with aAAA with similar characteristics of age, gender and preoperative risk factors. All available clinical, pathologic and postoperative variables were reviewed retrospectively, and the two groups were compared. Results    In comparison with aAAA, patients with iAAA were more symptomatic significantly (100% vs. 42.4%, P=0.001) and had larger aneurysm size on admission ［(7.4±0.7)cm vs. (6.3±0.9) cm，P=0.006］, and preoperative erythrocyte sedimentation rate was found to be elevated significantly ［(44.5±9.1)mm/h vs. (11.4±5.4)mm/h，P<0.05］. Surgical morbidity and mortality rates did not differ between two groups. The operation time of patients with iAAA was longer than patients with aAAA significantly ［(308±36)min vs. (224±46)min, P<0.05］, and cross-clamp time was similar in both groups［(41.5±6.2) min vs. (41.8±6.2)min, P= 0.92］. A five-year survival rate analysis showed no significant difference between two groups (P=0.711) . Conclusion    Despite the more symptomatic, larger size and long operation time of iAAA, iAAA can be treated with low morbidity and mortality similar as aAAA now. Long term effect of iAAA is of no difference from aAAA.

Key words: inflammatory abdominal aortic aneurysm, atherosclerotic abdominal aortic aneurysm