Analysis And Evaluation Of Treatment Of Abdominal Aortic Aneurysm

Objective Analysis etiology of abdominal aortic aneurysms, and evaluate therapeutic effectiveness of OR and EVAR of AAA and the difference of the cost effectiveness.Materials and methods The first part257cases AAA patients’ information is pooled, which has been diagnosed by color Doppler, MSCTA or DSA. We collect the main information such like gender, age and body weight, race, blood type, height weight with and without hypertension, diabetes, smoking, drinking, pulse pressure, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, apolipoprotein A1, apolipoprotein B, apolipoprotein A1/B, homocysteine, lipoprotein a, endogenous creatinine clearance rate, Cystatin HGB, serum, liver and kidney cyst,, gallstones, kidney stones. Depend on the collected index, we compare the difference of symptoms of abdominal aortic aneurysm and asymptomatic abdominal aortic aneurysm, trying to find the etiology and risk factors associated with the pathogenesis of abdominal aortic aneurysm.with attempt to provide help for prevention and early diagnosis of AAA. The second part Retrospective analysis 145cases of AAA which have been treated by the surgery in our hospital during2003to2013.Through follow-up investigation, All the AAA patients medical records get into a retrospectively study within March-5years following up after surgery.index such like gender, age, AAA body size, type, treatment method, complications, prognosis, total mortalities and quality of life. Qualify the effectiveness of open surgery and ERVR. The third part Meta analysis about the cost effectiveness of OR and EVAR.Results The first part of shows:abdominal aortic aneurysm symptoms and asymptomatic abdominal aortic aneurysm had the obvious difference in the body mass index of patients. Obesity is more common to see in the symptomatic of abdominal aortic aneurysm (P<0.05). Smoking, WBC, HGB, FIB, NEUT, MONO, Bilirubin, Total Protein, Albumin, TBA, AST, Homocysteine, APTT is common in patients with symptoms of abdominal aortic aneurysm (P<0.05). Aortic and peripheral arterial and AAA is clearly related, the incidence of male was higher than female. Age, BMI and is positive correlation with AAA formation. Biochemical studies showed high lever serum lipoprotein related with AAA. High endogenous creatinine clearance rate, cystatin, and MPV maybe act a important role to promote the formation of AAA. When analysis on the ethnic group in the Han nationality, we find the incidence rate is higher than other ethnic groups. The second part shows the treatment result of AAA. EVAR has less blood lost and less operation time, better quality of life in patients during the perioperation period, effective cost is higher than the open surgery group, the mortality difference is not obvious. The third part shows conclusion of the six studies about the effectiveness and cost of AAA repair which are pooled in the end,traditional open surgery is more cost-effective than EVAR.Conclusion The first part Obesity, Smoking, WBC, HGB, FIB, NEUT, Mono, Bilirubin, Total Protein, Albumin, TBA, AST, Homocysteine, APTT can be used as a screening process to find that symptomatic abdominal aortic aneurysm.2gender, age, nationality, blood, blood lipid, hypertension, body weight, MPV, endogenous creatine clearance rate serum cystatin deposit a certain correlation with AAA. The second part EVAR is a good treatment suitable for AAA, can be used as a treatment choice for AAA. The third part EVAR is a effective treatment to AAA, but more expensive than traditional open surgery.