中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2011年
11期
907-909
,共3页
戈小虎%方青波%管圣%赛里木%任昊
戈小虎%方青波%管聖%賽裏木%任昊
과소호%방청파%관골%새리목%임호
动脉瘤,夹层%主动脉瘤,胸%支架%腔内隔绝
動脈瘤,夾層%主動脈瘤,胸%支架%腔內隔絕
동맥류,협층%주동맥류,흉%지가%강내격절
Aneurysm,dissecting%Aortic aneurysm,thoracic%Stents%Endovascular isolation
目的 探讨腔内胸主动脉修复术治疗Stanford B型夹层的临床价值.方法 回顾性分析2006年1月至2011年4月126例行腔内胸主动脉修复术的B型主动脉夹层患者的临床资料,其中男86例,女40例；年龄32～82岁,平均(56±8)岁.在数字减影血管造影(digital subtraction angiography,DSA)监控下,切开股动脉,将带膜支架置于胸主动脉内膜破口处,封堵破口.术后影像学随访观察有无内漏、移位和支架塌陷等术后并发症.结果 126例手术成功,释放支架157枚.所有患者原发胸主动脉夹层破口完全封闭,真腔血流恢复,受损脏器功能恢复正常.术后82例患者获得随访,随访率65％,随访时间3～63个月,平均随访时间(26±8)个月.复查显示无内漏、移位等并发症,围手术期死亡2例,随访死亡1例,12例出现支架尾部破口,再次行腔内隔绝,1例术后出现逆行性A型夹层.结论 腔内胸主动脉修复术是治疗Stanford B型夹层具有技术可靠,安全性高,术后恢复快等优点.
目的 探討腔內胸主動脈脩複術治療Stanford B型夾層的臨床價值.方法 迴顧性分析2006年1月至2011年4月126例行腔內胸主動脈脩複術的B型主動脈夾層患者的臨床資料,其中男86例,女40例；年齡32～82歲,平均(56±8)歲.在數字減影血管造影(digital subtraction angiography,DSA)鑑控下,切開股動脈,將帶膜支架置于胸主動脈內膜破口處,封堵破口.術後影像學隨訪觀察有無內漏、移位和支架塌陷等術後併髮癥.結果 126例手術成功,釋放支架157枚.所有患者原髮胸主動脈夾層破口完全封閉,真腔血流恢複,受損髒器功能恢複正常.術後82例患者穫得隨訪,隨訪率65％,隨訪時間3～63箇月,平均隨訪時間(26±8)箇月.複查顯示無內漏、移位等併髮癥,圍手術期死亡2例,隨訪死亡1例,12例齣現支架尾部破口,再次行腔內隔絕,1例術後齣現逆行性A型夾層.結論 腔內胸主動脈脩複術是治療Stanford B型夾層具有技術可靠,安全性高,術後恢複快等優點.
목적 탐토강내흉주동맥수복술치료Stanford B형협층적림상개치.방법 회고성분석2006년1월지2011년4월126례행강내흉주동맥수복술적B형주동맥협층환자적림상자료,기중남86례,녀40례；년령32～82세,평균(56±8)세.재수자감영혈관조영(digital subtraction angiography,DSA)감공하,절개고동맥,장대막지가치우흉주동맥내막파구처,봉도파구.술후영상학수방관찰유무내루、이위화지가탑함등술후병발증.결과 126례수술성공,석방지가157매.소유환자원발흉주동맥협층파구완전봉폐,진강혈류회복,수손장기공능회복정상.술후82례환자획득수방,수방솔65％,수방시간3～63개월,평균수방시간(26±8)개월.복사현시무내루、이위등병발증,위수술기사망2례,수방사망1례,12례출현지가미부파구,재차행강내격절,1례술후출현역행성A형협층.결론 강내흉주동맥수복술시치료Stanford B형협층구유기술가고,안전성고,술후회복쾌등우점.
Objective To evaluate thoracic endovascular aortic repair for type B aortic dissection.Methods Chnical data were reviewed on 126 cases with type B aortic dissection undergoing endovascular aortic repair in our hospital from January 2006 to April 2011.There were 86 male patients and 40 female patients,age from 32 to 82 years.The stent- grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Postoperatively patients were followed-up by angiography and imiging for endoleak,stent migration,and fracture of stent-graft.Results In all cases,the aortic dissection tears were closed,true lumens were opened,and organ function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA from 3 to 63 months after endovascular therapy.Procedure was successful in all 126 cases,157 stents were released,2 cases died in the perioperative period,1 case died during the followed-up.A breach was found at the end of the stent in 12 cases,endovascular aortic repair redone successfully with a retrograde type A dissection found during follow-up.Conclusions Endovascular aortic repair is safe and effective for patients with Stanford type B aortic dissection with a favorable outcomes.
