腹主动脉瘤腔内修复术中封闭髂内动脉后的并发症

北京大学学报（医学版） ›› 2014, Vol. 46 ›› Issue (6): 917-919.

腹主动脉瘤腔内修复术中封闭髂内动脉后的并发症

栾景源1，李选1△，向勇2，傅军1，王昌明1，李天润1，韩金涛1

（1.北京大学第三医院介入血管外科，北京100191；2.贵州安顺市人民医院介入科，贵州安顺 561000）

出版日期:2014-12-18 发布日期:2014-12-18

Prognosis of embolization of internal iliac artery during the endovascular repair for abdominal aortic aneurysm

LUAN Jing-yuan1, LI Xuan1△, XIANG Yong2, FU Jun1, WANG Chang-ming1, LI Tian-run1, HAN Jin-tao1

(1.Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100191, China; 2.Department of Interventional Radiology, Anshun People’s Hospital, Guizhou Anshun 561000, China)

Online:2014-12-18 Published:2014-12-18

摘要/Abstract

摘要： 目的：探讨腹主动脉瘤腔内修复术中保留髂内动脉的重要性。方法：回顾北京大学第三医院连续46例腹主动脉瘤腔内修复术，分析封闭髂内动脉的并发症及转归情况。结果：46例腔内修复术中有18例保留双侧髂内动脉，随访16例均未发生并发症。其余28例（60.9%）封闭一侧或双侧髂内动脉，其中封闭双侧7例（15.2%），封闭右侧14例（30.4%），封闭左侧7例（15.2%）；随访26例中，发生臀部疼痛12例（46.2％），排便习惯改变8例（32.0％），勃起功能障碍3例（12.0％），便血2例（8.0％）。对比封闭双侧和封闭单侧髂内动脉，臀肌疼痛的发生率分别为50.0%、45.0%，臀肌疼痛平均缓解时间分别为8.3个月、4.7个月，排便习惯改变发生率分别为33.3%、31.6%，勃起功能障碍发生率分别为33.3%、5.3%。对比封闭左侧和封闭右侧髂内动脉，臀肌疼痛的发生率分别为57.1%、38.5%，臀肌疼痛平均缓解时间分别为6.0个月、 3.7个月，排便习惯改变发生率分别为57.1%、16.7%，便血发生率分别为28.6%、0。结论：腹主动脉瘤腔内修复术中应尽量保留髂内动脉，尤其是左侧髂内动脉。

关键词: 主动脉瘤, 腹, 血管成形术, 髂动脉, 手术后并发症

Abstract: Objective：To study the importance of the internal iliac artery (IIA) during the endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Forty-six consecutive cases of AAA treated by EVAR were retrospectively analyzed. The complications after exclusion of the IIA were analyzed. Results: The bilateral IIAs were reserved in 18 cases, in which the follow-up was achieved in 16 cases and no complication was observed. The IIAs were excluded in 28 (60.9%) cases, in which the bilateral, right and left IIAs were excluded in 7 (15.2%), 14 (30.4%) and 7 (15.2%) cases respectively. The follow-up was achieved in 26 cases. Buttock claudication was observed in 12 (46.2%) cases, altered bowel habit was observed in 8 (32.0%) cases, erectile dysfunction was observed in 3 (12.0%) cases, and bloody stool was observed in 2 (8.0%) cases. Comparing the bilateral and unilateral IIA exclusions, the rates of buttock claudication were 50.0% vs. 45.0%, altered bowel habit 33.3% vs. 31.6%, and erectile dysfunction 33.3% vs. 5.3% respectively. And the average duration of buttock claudication of bilateral IIAs exclusion (8.3 months) was longer than that of unilateral exclusion (4.7 months). Moreover, comparing the left and right IIA exclusions, the rates of buttock claudication were 57.1% vs. 38.5%, altered bowel habit 57.1% vs. 16.7%, and bloody stool 28.6% vs. 0 respectively. And the average duration of buttock claudication of left IIA exclusion (6.0 months) was longer than that of right exclusion (3.7 months). Conclusion: The IIAs, especially the left IIA, should be reserved during the EVAR for AAA.

Key words: Aortic aneurysm, abdominal, Angioplasty, Iliac artery, Postoperative complications

栾景源, 李选, 向勇, 傅军, 王昌明, 李天润, 韩金涛. 腹主动脉瘤腔内修复术中封闭髂内动脉后的并发症[J]. 北京大学学报（医学版）, 2014, 46(6): 917-919.

LUAN Jing-Yuan, LI Xuan, XIANG Yong, FU Jun, WANG Chang-Ming, LI Tian-Run, HAN Jin-Tao. Prognosis of embolization of internal iliac artery during the endovascular repair for abdominal aortic aneurysm[J]. Journal of Peking University(Health Sciences), 2014, 46(6): 917-919.

参考文献

相关文章 15

[1]	侯婉音,董捷. 腹膜透析患者获得性肾囊肿出血3例[J]. 北京大学学报（医学版）, 2024, 56(3): 546-550.
[2]	毛海,张帆,张展奕,颜野,郝一昌,黄毅,马潞林,褚红玲,张树栋. 基于MRI前列腺腺体相关参数构建腹腔镜前列腺癌术后尿失禁的预测模型[J]. 北京大学学报（医学版）, 2023, 55(5): 818-824.
[3]	邱敏,宗有龙,王滨帅,杨斌,徐楚潇,孙争辉,陆敏,赵磊,卢剑,刘承,田晓军,马潞林. 腹腔镜肾部分切除术治疗中高复杂程度肾肿瘤的效果[J]. 北京大学学报（医学版）, 2023, 55(5): 833-837.
[4]	刘慧丽,吕彦函,王晓晓,李民. 老年患者腹腔镜泌尿系肿瘤根治术后慢性疼痛的影响因素[J]. 北京大学学报（医学版）, 2023, 55(5): 851-856.
[5]	许素环,王蓓蓓,庞秋颖,钟丽君,丁炎明,黄燕波,车新艳. 等体温膀胱冲洗对经尿道前列腺电切术患者干预效果的meta分析[J]. 北京大学学报（医学版）, 2023, 55(4): 676-683.
[6]	田慈,白颐,马青变,葛洪霞. 7例肝门静脉积气的临床特征分析[J]. 北京大学学报（医学版）, 2023, 55(4): 743-747.
[7]	乔婕,芦丽霞,何玉婷,门春翠,楚新新,武蓓,赵慧萍,王梅. 真菌性腹膜透析导管出口感染合并隧道感染1例[J]. 北京大学学报（医学版）, 2023, 55(4): 748-754.
[8]	李辉,高阳旭,王书磊,姚红新. 恶性肿瘤患儿完全植入式静脉输液港手术并发症[J]. 北京大学学报（医学版）, 2022, 54(6): 1167-1171.
[9]	张铃福,侯纯升,徐智,王立新,凌晓锋,王港,崔龙,修典荣. 腹腔镜下经胆囊管胆管引流联合胆总管探查取石术治疗复杂胆管结石的临床效果[J]. 北京大学学报（医学版）, 2022, 54(6): 1185-1189.
[10]	李芷晴,俞冰,蔡泽宇,王迎宝,张煦,周彪,方晓红,于芳,付毅,孙金鹏,李伟,孔炜. 柚皮素抑制马凡综合征小鼠胸主动脉瘤的形成[J]. 北京大学学报（医学版）, 2022, 54(5): 896-906.
[11]	安立哲,熊六林,陈亮,王焕瑞,陈伟男,黄晓波. 腹腔镜肾盂成形术联合肾盂镜超声碎石取石术治疗肾盂输尿管连接部梗阻合并肾结石[J]. 北京大学学报（医学版）, 2022, 54(4): 746-750.
[12]	张帆,陈曲,郝一昌,颜野,刘承,黄毅,马潞林. 术前及术后膜性尿道长度与腹腔镜根治性前列腺切除术后控尿功能恢复的相关性[J]. 北京大学学报（医学版）, 2022, 54(2): 299-303.
[13]	李伟浩,李伟,张学民,李清乐,焦洋,张韬,蒋京军,张小明. 去分支杂交手术和传统手术治疗胸腹主动脉瘤的结果比较[J]. 北京大学学报（医学版）, 2022, 54(1): 177-181.
[14]	魏慧,罗增,次旦央宗,白玛央金. 高原地区不同海拔高度腹型过敏性紫癜患者临床特征分析[J]. 北京大学学报（医学版）, 2021, 53(6): 1072-1077.
[15]	张帆,黄晓娟,杨斌,颜野,刘承,张树栋,黄毅,马潞林. 前列腺尖部深度与腹腔镜前列腺癌根治术后早期控尿功能恢复的相关性[J]. 北京大学学报（医学版）, 2021, 53(4): 692-696.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed