充分的术前评估是伴合并症腹主动脉瘤手术成功的提前

2020-11-30 《门诊》杂志 门诊新视野

动脉粥样硬化是导致腹主动脉瘤的一个重要原因,同时也是引起冠状动脉狭窄的重要原因。因此,腹主动脉瘤患者常常合并冠心病等心血管相关疾病。

动脉粥样硬化是导致腹主动脉瘤的一个重要原因,同时也是引起冠状动脉狭窄的重要原因。因此,腹主动脉瘤患者常常合并冠心病等血管相关疾病。在西北第八届主动脉疾病高峰论坛期间,《门诊》杂志特邀榆林市第二医院胸外心脏大血管外科的白和平副主任医师接受采访,分享了腹主动脉瘤伴合并症患者的治疗方面的心得体会。
动脉粥样硬化是腹主动脉瘤的一个重要原因,同时也是冠状动脉狭窄的重要原因,因此腹主动脉瘤患者常常合并冠心病。您在日常工作中接触的患者腹主动脉瘤患者合并冠心病的情况是否多见?对于合并冠脉疾病的腹主动脉瘤患者,一般会先处理哪一处的病变?

白和平副主任医师:近年来,随着诊断水平的提高,腹主动脉瘤的检出率逐步提升,且大部分为60岁以上的老年患者。国外的数据,在腹主动脉瘤患者中约90%合并冠心病;其主要原因是腹主动脉瘤患者的全身血管基础较差,进而增加了合并冠心病的概率,同时内脏动脉、脑部动脉等出现病变的概率也会增加。在临床中,临床医师会常规建议腹主动脉瘤患者做冠脉CTA或DSA检测;提前诊断并进行处理,利于患者的长期生存情况。

对于合并冠脉疾病的腹主动脉瘤的处理,一般要根据患者的情况个体化的选择策略。若该患者的冠脉疾病相对更加危重、紧急,则建议先处理冠脉病变;待其心功能改善后,患者的耐受情况也会好转,再处理其他病变也更顺畅。但是,若该患者腹主动脉瘤破裂或即将破裂,则应先处理腹主动脉瘤,再行冠脉手术。

结合您在此次会议中的演讲内容“一站式解决腹主动脉瘤合并冠心病伴心衰患者1例”,您认为腹主动脉瘤合并冠心病患者预后的影响因素有哪些,如何改善预后?

白和平副主任医师:在本次会议上,我分享了1例腹主动脉瘤合并冠心病伴心衰的病例;该患者为77岁男性,因胸、背、腹部疼痛9小时入院,既往高血压、糖尿病病史;CTA显示腹主动脉瘤、附壁血栓以及冠脉重度狭窄。术前评估发现该患者射血分数仅为34%,经相关科室会诊后决定先处理冠脉疾病。因此,首先由心内科的医师对冠脉的两处病变分别予以支架植入术和药涂球囊扩张术。术后患者胸闷、气短等症状明显改善;1周后其射血分数提高至52%。随后采用覆膜支架植入术处理了腹主动脉瘤病变,术后造影显示支架形态良好、无内漏。出院时,患者症状消失,身体状态良好。

腹主动脉瘤预后的影响因素有很多,包括瘤体的大小、是否破裂、距内脏血管的距离、瘤颈的长度、扭曲程度以及直径、入路血管的情况等。术前充分的评估测量,选择合适的支架;术中精准的操作;以及术后密切的随访管理都有助于改善患者预后。对于年龄较大的腹主动脉瘤患者,就诊时往往会发现全身有多处合并症的情况;首先诊断出其合并症,针对性的制定治疗策略对改善预后非常重要。

研究发现腹主动脉瘤合并冠心病患者的长期生存率明显低于非合并冠心病患者,冠心病是否可能造成腹主动脉瘤患者治疗后预后不良?您认为出现这一现象的原因有哪些?

白和平副主任医师:对于合并冠心病的腹主动脉瘤的诊治,部分患者在手术之前,可能会因冠心病发作,严重的心律失常,或心衰,导致死亡。还有部分患者,在处理腹主动脉疾病的术中,突发心律失常、或心衰加重导致死亡。此外,对于合并有冠心病的腹主动脉瘤患者术后的管理,包括饮食、用药等各方面也都要非常谨慎,避免诱发冠心病的发作。需要注意的是,对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。

 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
    2021-04-01 1881ef655dm

    好好好

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
    2021-09-21 lvliquan
  3. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
    2020-12-01 392534278

    学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
    2020-12-01 1211c54em14(暂无昵称)

    合并冠心病患者,手术风险加大

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=953123, encodeId=321a95312343, content=好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66942067627, createdName=1881ef655dm, createdTime=Thu Apr 01 17:34:38 CST 2021, time=2021-04-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1825892, encodeId=2633182589263, content=<a href='/topic/show?id=c52d388137b' target=_blank style='color:#2F92EE;'>#合并症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38813, encryptionId=c52d388137b, topicName=合并症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Sep 21 15:55:43 CST 2021, time=2021-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415718, encodeId=aeb51415e1897, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429075, encodeId=c7f714290e576, content=<a href='/topic/show?id=ee192321560' target=_blank style='color:#2F92EE;'>#主动脉瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23215, encryptionId=ee192321560, topicName=主动脉瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95e34160730, createdName=fengting4, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490432, encodeId=2da61490432af, content=<a href='/topic/show?id=52476102342' target=_blank style='color:#2F92EE;'>#术前评估#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61023, encryptionId=52476102342, topicName=术前评估)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8afa8737210, createdName=ay2003fy, createdTime=Wed Dec 02 14:55:43 CST 2020, time=2020-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904000, encodeId=3f2890400040, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201201/cade54d2b9b64947848f5d0b9b288c9a/6c5d0b4cc9cd44a7851dffb52b24dc89.jpg, createdBy=fdb44694234, createdName=392534278, createdTime=Tue Dec 01 21:01:52 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903848, encodeId=df9890384864, content=合并冠心病患者,手术风险加大, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60182229007, createdName=1211c54em14(暂无昵称), createdTime=Tue Dec 01 13:09:03 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903818, encodeId=1f4290381824, content=对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210325/2d9c955949df4b349a439f1a6773499e/b39f4845e869489d95bc545c79cf60fa.jpg, createdBy=303f5433779, createdName=Oranhyg, createdTime=Tue Dec 01 10:57:37 CST 2020, time=2020-12-01, status=1, ipAttribution=)]
    2020-12-01 Oranhyg

    对于年轻患者、耐受力较强,一般不推荐腔内手术。但是大部分合并冠心病的腹主动脉瘤患者年龄较大、耐受力较差,因此一般建议行腔内手术。

    0

相关资讯

DCR:术前使用阿片类药物,镇静剂或抗抑郁药与结直肠手术的不良结局相关

在过去的十几年中,阿片类药物,镇静剂和抗抑郁药的使用正在迅猛增加。但目前尚未确定这些药物对结直肠手术结局的影响。因此,本研究旨在评估大肠手术手术前使用阿片类药物,镇静剂和抗抑郁药对术后结局的影响。

对于复杂腹主动脉瘤的治疗,开放手术不可或缺

腹主动脉瘤是血管外科常见疾病之一,一旦破裂,病死率高达70%~95%,严重威胁患者的健康和生命。对于腹主动脉瘤患者的治疗,首先应予以药物保守治疗以抑制腹主动脉瘤的生长。

DCR:肛周脓肿手术治疗的危险因素分析

直肠肛周脓肿是一个常见的临床问题,据估计每年约有100000例病例发生,极大影响人们的正常生活作息。

一文详解膝关节骨性关节炎的治疗

膝关节骨性关节炎是最常见的中老年性关节疾病,以关节软骨的变性、破坏及骨质增生为特征的慢性关节病,经常并发半月板的撕裂、软骨的剥脱、韧带的松弛等病理改变。

BMJ:肿瘤治疗延迟与死亡风险研究

肿瘤治疗延迟是严重的公共卫生问题,研究表明,即使癌症治疗延迟4周,也与七种肿瘤的手术、全身治疗和放射治疗后死亡率增加有关

 JCC: 克罗恩病患者回盲瓣行侧侧狭窄成型术可以改善长期预后

考虑到克罗恩病[CD]的性质,手术治疗无法治愈。大约50%的患者将在4-6个月内早期内镜下复发。10年后的临床和手术复发率分别可以达到50%和20%。