CAJ | 학술논문

目的比较多平面重建（MPR）技术与经验性定位在Stanford B型主动脉夹层腔内修复术中的临床应用价值。方法选择2012年5月至2013年3月Stanford B型主动脉夹层患者40例（A组）：术前分别采用经验性和MPR两种方法获得C形臂的旋转角度和倾斜角度，比较两种方法的差异；术中采用MPR技术确定角度，统计支架释放后近端标记点的散开率和各种并发症的发生率。另42例Stanford B型主动脉夹层患者采用经验性方法释放支架（B组）：计算近端标记点散开率和各种并发症的发生率。分析两组支架标记点散开率和并发症发生率。结果 A组内经验性方法和MPR方法之间旋转角度及倾斜角度比较，差异有统计学意义（P均<0.05）；A、B两组标记点散开率比较，差异有统计学意义（5.0%v s 42.9%，P<0.05）；A、B两组并发症发生率比较，差异有统计学意义（5.0%v s 21.4%，P<0.05）。结论结合MPR技术进行Stanford B型主动脉夹层腔内治疗术中定位调整，指导手术操作，具有较好的可行性、有效性及安全性。
목적비교다평면중건（MPR）기술여경험성정위재Stanford B형주동맥협층강내수복술중적림상응용개치。방법선택2012년5월지2013년3월Stanford B형주동맥협층환자40례（A조）：술전분별채용경험성화MPR량충방법획득C형비적선전각도화경사각도，비교량충방법적차이；술중채용MPR기술학정각도，통계지가석방후근단표기점적산개솔화각충병발증적발생솔。령42례Stanford B형주동맥협층환자채용경험성방법석방지가（B조）：계산근단표기점산개솔화각충병발증적발생솔。분석량조지가표기점산개솔화병발증발생솔。결과 A조내경험성방법화MPR방법지간선전각도급경사각도비교，차이유통계학의의（P균<0.05）；A、B량조표기점산개솔비교，차이유통계학의의（5.0%v s 42.9%，P<0.05）；A、B량조병발증발생솔비교，차이유통계학의의（5.0%v s 21.4%，P<0.05）。결론결합MPR기술진행Stanford B형주동맥협층강내치료술중정위조정，지도수술조작，구유교호적가행성、유효성급안전성。
Objective To analyze application value of multi-planar reconstruction (MPR) in the aortic arch positioning of endovascular repair of type B aortic dissection. Methods A group of 40 patients (group A) was sampled from May 2012 to March 2013. The conventional and the MPR approaches were respectively introduced on positioning the aortic arch for surgery. Statistical significance of the difference of spin and tilt angles was obtained from the patients using both approaches before operation. The MPR data guided stent-grafting in this group. Another group of 42 patients (group B) was sampled and their stent graft placement was based on the conventional approach. Percentages of proximal distributed markers as well as incidences of complications were collected from both groups after stent graft placement. Results A significant difference was found between the conventional and the MPR approaches for spin angle as well as tilt angle (P<0.05). Percentage of proximal distributed markers of group A (5.0%) was significantly lower than that of group B (42.9%) (P<0.05). Incidence of complications of group A (5.0%) was also significantly lower than that of group B (21.4%) (P<0.05). Conclusion MPR technology can apply to intraoperative positioning adjustment. It is feasible in endovascular treatment of type B aortic dissection, and can effectively and safely guide surgical operations.