Shindo Shunya, Motohashi Shinya, Katsu Masatake, Kaga Shigeaki, Inoue Hidenori, Matsumoto Masahiko
Second Department of Surgery, University of Yamanashi, Chuo-city, Yamanashi, Japan.
Artif Organs. 2008 Mar;32(3):183-7. doi: 10.1111/j.1525-1594.2007.00521.x. Epub 2008 Jan 15.
This prospective study was conducted to compare inflammatory responses between patients receiving coated and uncoated vascular prostheses, and to examine their effect on length of stay and cost of patients undergoing abdominal aortic aneurysmectomy. Patients undergoing elective vascular reconstruction of an abdominal aortic aneurysm were assigned randomly to coated-graft or uncoated-graft groups (n = 20, for each group). Interleukin (IL)-6, granulocyte elastase, white blood cell count, C-reactive protein (CRP), and body temperature (BT) were prospectively recorded preoperatively and on postoperative days (PODs) 1, 3, 7, and 14. In-hospital stay and hospitalized costs were also analyzed. IL-6 and CRP concentrations in the coated-graft group were higher than those in the uncoated-graft group (P = 0.01 and 0.05). BT was more frequently elevated >37 degrees C at POD 14 in the coated-graft group than in the uncoated-graft group (P =0.03). Discharge was delayed, and overall hospitalization cost was higher in the coated-graft group than in the uncoated group (17.6 vs. 13.5 days, and 2 010 000 vs. 1 780 000 yen, P = 0.006 and P = 0.002, respectively). Coated vascular prosthesis demonstrated more profound inflammatory reaction than noncoated prosthesis, postoperatively.
本前瞻性研究旨在比较接受带涂层和不带涂层血管移植物的患者之间的炎症反应，并研究其对腹主动脉瘤切除术患者住院时间和费用的影响。接受择期腹主动脉瘤血管重建术的患者被随机分为带涂层移植物组和不带涂层移植物组（每组n = 20）。前瞻性记录术前以及术后第1、3、7和14天的白细胞介素（IL）-6、粒细胞弹性蛋白酶、白细胞计数、C反应蛋白（CRP）和体温（BT）。还分析了住院时间和住院费用。带涂层移植物组的IL-6和CRP浓度高于不带涂层移植物组（P = 0.01和0.05）。带涂层移植物组术后第14天体温>37摄氏度的情况比不带涂层移植物组更频繁（P = 0.03）。带涂层移植物组的出院延迟，总体住院费用高于不带涂层组（分别为17.6天对13.5天，2 010 000日元对1 780 000日元，P = 0.006和P = 0.002）。术后，带涂层血管移植物比不带涂层移植物表现出更强烈的炎症反应。
