血管内动脉瘤修复术比开放性腹主动脉瘤修复术相关的营养不良发生率更低。
Endovascular aneurysm repair is associated with less malnutrition than open abdominal aortic aneurysm repair.
机构信息
Department of Surgery, VA Connecticut Healthcare System, West Haven, CT, USA.
出版信息
Am J Surg. 2009 Nov;198(5):623-7. doi: 10.1016/j.amjsurg.2009.07.022.
BACKGROUND
Patients undergoing abdominal aortic aneurysm (AAA) repair have high rates of postoperative malnutrition. We examined whether endovascular aneurysm repair (EVAR) is associated with reduced postoperative malnutrition compared with open AAA repair.
METHODS
The records of patients undergoing AAA repair in the Veterans Affairs (VA) Connecticut Healthcare System were reviewed. Primary outcomes were 30-day morbidity, lengths of hospitalization and intensive care unit stay, duration of intubation, and nutritional risk index scores.
RESULTS
Sixty-two patients were included (open repair, 37; EVAR, 25). Nutritional parameters were comparable between groups before surgery. Patients treated with EVAR had improved postoperative nutritional profiles as determined by albumin level (3.7 +/- .08 vs 3.2 +/- .12; P = .003), and nutritional risk index (97.9 +/- 1.3 vs 88.9 +/- 1.8; P = .0006), compared with patients treated with open repair.
CONCLUSIONS
Patients undergoing EVAR developed significantly less postoperative malnutrition compared with those having open repair. EVAR may be a strategy to avoid malnutrition and improve outcomes in patients at risk for malnutrition after undergoing AAA repair.
背景
接受腹主动脉瘤 (AAA) 修复的患者术后营养不良发生率较高。我们研究了与开放 AAA 修复相比，血管内动脉瘤修复 (EVAR) 是否与减少术后营养不良相关。
方法
回顾退伍军人事务部 (VA) 康涅狄格医疗保健系统中接受 AAA 修复的患者记录。主要结果是 30 天发病率、住院和重症监护病房停留时间、插管时间和营养风险指数评分。
结果
纳入 62 例患者（开放修复 37 例，EVAR 25 例）。手术前两组的营养参数相当。与接受开放修复的患者相比，接受 EVAR 治疗的患者术后营养状况改善，白蛋白水平（3.7 +/-.08 与 3.2 +/-.12；P =.003）和营养风险指数（97.9 +/- 1.3 与 88.9 +/- 1.8；P =.0006）。
结论
与接受开放修复的患者相比，接受 EVAR 的患者术后营养不良明显减少。EVAR 可能是一种避免营养不良和改善接受 AAA 修复后有营养不良风险的患者结局的策略。
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