本文選題：主動(dòng)脈瘤 + 腹��； 參考：《青島大學(xué)》2015年碩士論文

【摘要】：目的:通過(guò)對(duì)已行腹主動(dòng)脈瘤腔內(nèi)修復(fù)術(shù)患者的影像學(xué)資料進(jìn)行重建及測(cè)量,評(píng)估瘤頸、瘤體相關(guān)指標(biāo)間的關(guān)系以及這些指標(biāo)對(duì)臨床療效的影響,探討近端瘤頸、瘤體形態(tài)在EVAR圍手術(shù)期的意義。方法:收集2009年1月至2014年9月期間于我院診療并行腹主動(dòng)脈瘤腔內(nèi)修復(fù)術(shù)的患者的術(shù)前動(dòng)脈CTA圖像,應(yīng)用Osirix影像處理軟件對(duì)其進(jìn)行二維及三維重建,并對(duì)近端瘤頸及瘤體相關(guān)指標(biāo)進(jìn)行測(cè)量和評(píng)估,通過(guò)住院病人病歷檢索系統(tǒng)檢索患者圍手術(shù)期臨床資料,統(tǒng)計(jì)分析近端瘤頸及瘤體形態(tài)相關(guān)指標(biāo)間的關(guān)系及其對(duì)EVAR術(shù)后療效的影響。結(jié)果:近端瘤頸腎動(dòng)脈下緣水平直徑與頸體交界處直徑呈中度正相關(guān)(r=0.744,P0.001),瘤腔最大直徑與瘤體最大直徑呈中度正相關(guān)(r=0.666,P0.001),瘤體直徑與瘤體長(zhǎng)度呈中度正相關(guān)(r=0.594,P0.001),近端瘤頸直徑與瘤體最大直徑呈低度正相關(guān),近端瘤頸長(zhǎng)度與瘤體長(zhǎng)度呈中度負(fù)相關(guān)(r=-0.545,P0.001),而近端瘤頸長(zhǎng)度與瘤體直徑無(wú)明顯相關(guān)性(r=-0.120,P=0.208)。近端瘤頸長(zhǎng)度和成角以及瘤體直徑和長(zhǎng)度均可影響近端I型內(nèi)漏的發(fā)生。結(jié)論:近端瘤頸直徑在腎動(dòng)脈下緣水平越大,則在頸體交界處也越大,但在選擇支架型號(hào)及材料時(shí)需結(jié)合近端瘤頸整體形態(tài)構(gòu)型;瘤體直徑是影響近端瘤頸及瘤體形態(tài)其他指標(biāo)的最重要因素,若瘤體直徑越大,則近端瘤頸直徑、瘤腔最大直徑以及瘤體長(zhǎng)度均越大,但瘤體直徑與近端瘤頸長(zhǎng)度無(wú)明顯相關(guān)性。近端瘤頸及瘤體形態(tài)異常是影響近端I型內(nèi)漏發(fā)生的重要因素,術(shù)前對(duì)AAA形態(tài)進(jìn)行精確測(cè)量及評(píng)估,術(shù)中及時(shí)發(fā)現(xiàn)、積極處理,仍是近端I型內(nèi)漏防治的關(guān)鍵所在。
[Abstract]:Objective: to evaluate the relationship between neck and tumor parameters and the effect of these parameters on the clinical efficacy of patients undergoing endovascular repair of abdominal aortic aneurysm by reconstructing and measuring the imaging data, and to explore the proximal aneurysm neck. The significance of tumor morphology in EVAR perioperative period. Methods: from January 2009 to September 2014, the preoperative arterial CTA images of patients treated in our hospital with endovascular repair of abdominal aortic aneurysms were collected and reconstructed by Osirix image processing software. The relative indexes of proximal neck and tumor were measured and evaluated, and the clinical data of patients during perioperative period were retrieved by the medical record retrieval system of inpatients. The relationship between proximal neck and tumor morphologic parameters and its effect on the curative effect after EVAR were analyzed statistically. Results: there was a moderate positive correlation between the horizontal diameter of the proximal carotid and renal artery and the diameter of the junction of the cervical body. The maximum diameter of the tumor cavity and the maximum diameter of the tumor were positively correlated with the maximum diameter of the tumor. There was a moderate positive correlation between the diameter of the tumor and the length of the tumor. The neck diameter was positively correlated with the maximum diameter of the tumor. There was a moderate negative correlation between the neck length of the proximal tumor and the length of the tumor body. However, there was no significant correlation between the neck length of the proximal tumor and the diameter of the tumor, and there was no significant correlation between the neck length of the proximal end tumor and the diameter of the tumor. The length and angle of the proximal neck and the diameter and length of the tumor can affect the occurrence of the proximal type I internal leakage. Conclusion: the larger the diameter of proximal neck is at the lower edge of renal artery, the greater is the size of the neck at the junction of the neck. However, the shape of proximal neck should be combined with the choice of stent type and material. The diameter of the tumor is the most important factor affecting the proximal neck and other parameters of tumor morphology. If the diameter of the tumor is larger, the diameter of the proximal neck, the maximum diameter of the tumor cavity and the length of the tumor are both larger. However, there was no significant correlation between the diameter of tumor and the length of proximal neck. The abnormal shape of proximal neck and tumor is an important factor that affects the occurrence of proximal type I internal leakage. The accurate measurement and evaluation of the shape of AAA before operation, the timely detection and active treatment during operation are still the key to the prevention and treatment of proximal type I internal leakage.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R654.3

【共引文獻(xiàn)】

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本文編號(hào)：1869513