【摘要】：背景:受限于高昂的覆膜支架費用和有限的循證醫(yī)學數據,腹主動脈瘤腔內修復術這一微創(chuàng)技術在國內的普及受到阻礙。為了降低費用,覆膜支架材料的國產化勢在必行,但是之前國產腹主動脈瘤覆膜支架的循證醫(yī)學數據仍然較少。目的:對比新型國產腹主動脈覆膜支架與進口覆膜支架(GORE EXCLUDER)腔內修復治療腹主動脈瘤的效果。方法:回顧性分析2014年1至11月在青島大學附屬醫(yī)院血管外科完成腹主動脈瘤腔內修復術32例腎下型腹主動脈瘤患者的臨床資料,其中采用國產覆膜支架(華脈泰科)11例,GORE EXCLUDER覆膜支架21例。患者均為男性,年齡56-79歲,平均(70.2±6.9)歲。于術后第1,6個月及之后每6個月行主動脈計算機斷層掃描血管造影檢查評估治療效果。結果與結論:(1)國產組支架組11例均成功植入華脈泰科覆膜支架,術后發(fā)現遲發(fā)Ⅰ型內漏1例,Ⅱ型內漏1例,1例術后髂支閉塞,1例死亡。共植入覆膜支架主體11枚,髂動脈覆膜支架18枚,Cuff支架1枚,裸支架1枚,平均2.8枚/人;(2)進口支架組21例均成功植入GORE EXCLUDER覆膜支架,技術成功率90%,術中造影發(fā)現Ⅰ型內漏2例(10%),術后復查發(fā)現Ⅰ型內漏2例,Ⅱ型內漏2例。共植入覆膜支架主體21枚,髂動脈覆膜支架28枚,Cuff支架3枚,平均2.47枚/人;(3)結果表明,新型國產腹主動脈覆膜支架治療腎下腹主動脈瘤取得了滿意的近-中期療效,各觀測指標與進口支架組差異無顯著性意義。但是國產覆膜支架的遠期療效仍有待進一步研究。
[Abstract]:Background: limited by the high cost of stenting and limited evidence-based medical data endovascular repair of abdominal aortic aneurysms this minimally invasive technology is hampered in China. In order to reduce the cost, it is necessary to make the stents domestic, but the evidence-based medical data of domestic stents for abdominal aortic aneurysms are still scarce. Aim: to compare the effect of endovascular repair of abdominal aortic aneurysm with (GORE EXCLUDER) stent. Methods: the clinical data of 32 patients with subrenal abdominal aortic aneurysm underwent endovascular repair from January to November 2014 in vascular surgery, affiliated hospital of Qingdao University, were retrospectively analyzed. GORE EXCLUDER covered stent in 21 cases. All the patients were male, aged 56-79 years (mean (70.2 鹵6.9) years). Aortic computed tomography angiography was performed at the 1st, 6th month and every 6 months after operation to evaluate the therapeutic effect. Results and conclusion: (1) in the domestic stent group, 11 cases were successfully implanted with Huametaike stent. Delayed type 鈪，

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