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目的 超声随访腹主动脉瘤切除术后腹主动脉颈部的变化。方法 对 1 0 2例腹主动脉瘤术后患者进行超声随访。每位患者平均接受 3次 ( 2～ 7次 )超声检查。术后随访中位时间 84个月 ( 2 4～ 2 1 6个月 )。结果 术后第 1次超声检查发现 4例腹主动脉颈部发生动脉瘤 (直径 >40mm)。在 44例患者 ,术后超声检查近端主动脉颈部的平均直径由 ( 2 6 .9± 1 .0 )mm增加到 ( 31 .0± 1 .2 )mm( P <0 .0 0 1 ) ,2 0例患者从 ( 30 .0± 0 .9)mm减小到 ( 2 6 .9± 1 .1 )mm( P <0 .0 1 ) ,其余 34例患者没有变化。术后第 1次检查结果与最后检查结果呈显著正相关 ( r=0 .84,P <0 .0 0 1 )。根据术后第 1次腹主动脉近端颈部直径检查结果将患者分为 2组 :Ⅰ组 (直径≤2 7mm) ,8.6 % ( 5 /5 8)的患者在最后检查时直径发展到 30mm以上 ;Ⅱ组 (直径 >2 7mm) ,6 5 .0 % ( 2 6 /4 0 )的患者直径发展到 30mm以上 ,其中 7例 ( 1 7.5 % )发生腹主动脉颈部动脉瘤 (直径 42～ 48mm)。结论 对腹主动脉瘤术后超声检查发现腹主动脉颈部直径 >2 7mm时应做长期随访。腹主动脉瘤颈部直径 <2 7mm可能更适合于进行腹主动脉瘤腔内修复术。
Objective To investigate the changes of abdominal aorta neck after abdominal aortic aneurysm resection. Methods One hundred and two patients with abdominal aortic aneurysm were followed up by ultrasound. Each patient received on average 3 (2 to 7) ultrasound exams. The median follow-up time was 84 months (range 2-4 to 216 months). Results After the first ultrasound examination, 4 cases of aneurysm of the abdominal aorta (diameter> 40mm) were found. In 44 patients, the average diameter of the proximal aortic neck after ultrasound examination increased from (26.9 ± 1.0) mm to (31.0 ± 1.2) mm (P <0.01) ), 20 patients decreased from (30.0 ± 0.9) mm to (26.9 ± 1.1) mm (P <0.01), and the other 34 patients had no change. There was a significant positive correlation between the first postoperative examination and the final examination (r = 0.84, P <0.001). The patients were divided into 2 groups according to the results of the first abdominal aorta neck diameter examination after operation: group Ⅰ (diameter ≤ 27mm) and 8.6% (5/58) patients developed diameter to 30mm (Diameter> 27mm), 65.0% (26/40) patients developed diameter more than 30mm, of which 7 cases (7.5%) had abdominal aortic neck aneurysm (diameter 42 ~ 48mm). Conclusion Long-term follow-up of abdominal aortic aneurysm after ultrasound examination found abdominal neck aortic diameter> 27mm should be followed up. Abdominal aortic aneurysm neck diameter <2 7mm may be more suitable for endovascular repair of abdominal aortic aneurysm.