CAJ | 학술논문

目的：观察覆膜支架腔内修复治疗复杂性 Stanford B型急性主动脉夹层的近中期预后。方法选取2009年1月—2011年1月在信阳市中心医院心内科治疗的复杂性Stanford B型急性主动脉夹层患者45例，入院后均采用药物严格控制血压、心率，均符合腔内修复治疗的指征，其中32例同意手术患者入选腔内修复治疗组（治疗组），13例拒绝腔内修复治疗的患者入选对照组。记录两组患者住院时间、住院期间病死率，随访36个月记录生存率。结果治疗组患者住院时间为（22.6±12.2）d ，长于对照组的（17.3±4.7）d（t=13.398，P=0.001）。治疗组患者住院期间病死率为3.1%（1/32），低于对照组的30.8%（4/13）（χ2=9.989，P=0.001）。随访12个月，治疗组与对照组患者生存率分别为96.9%、53.8%；随访36个月，治疗组与对照组患者生存率分别为96.9%、30.8%。治疗组与对照组患者36个月生存率比较，差异有统计学意义（χ2=24.06，P<0.01）。结论覆膜支架腔内修复治疗复杂性Stan-ford B型急性主动脉夹层预后优于单纯药物治疗。
목적：관찰복막지가강내수복치료복잡성 Stanford B형급성주동맥협층적근중기예후。방법선취2009년1월—2011년1월재신양시중심의원심내과치료적복잡성Stanford B형급성주동맥협층환자45례，입원후균채용약물엄격공제혈압、심솔，균부합강내수복치료적지정，기중32례동의수술환자입선강내수복치료조（치료조），13례거절강내수복치료적환자입선대조조。기록량조환자주원시간、주원기간병사솔，수방36개월기록생존솔。결과치료조환자주원시간위（22.6±12.2）d ，장우대조조적（17.3±4.7）d（t=13.398，P=0.001）。치료조환자주원기간병사솔위3.1%（1/32），저우대조조적30.8%（4/13）（χ2=9.989，P=0.001）。수방12개월，치료조여대조조환자생존솔분별위96.9%、53.8%；수방36개월，치료조여대조조환자생존솔분별위96.9%、30.8%。치료조여대조조환자36개월생존솔비교，차이유통계학의의（χ2=24.06，P<0.01）。결론복막지가강내수복치료복잡성Stan-ford B형급성주동맥협층예후우우단순약물치료。
Objective To evaluate the short - and med - term prognosis of thoracic endovascular aortic repair (TEVAR)in treatment of patients with complicated type B acute aortic dissection(AAD). Methods 45 patients with compli-cated type B AAD who were admitted to Department of Cardio Medicine,Xinyang Central Hospital from January 2009 to January 2011,were selected as study subjects. The blood pressure and heart rate of all patients were strictly controlled by medicine,all patients were suitable for endovascular aortic repair,32 patients who agreed to interrentional treatment were included into endo-vascular aortic repair group ( treatment group ), the rest 13 patients who denied surgical treatment were included into control group. Duration of hospital stays and mortality during hospitalization of two groups of patients were recorded,all patients were fol-lowed up for 36 months,and survival rate was recorded. Results Duration of hospital stays in treatment group〔(22. 6 ± 12. 2) d〕was significantly more than that in control group〔(17. 3 ±4. 7)d〕(t=13. 398,P=0. 001). Mortality during hospitaliza-tion in treatment group〔3. 1%(1/32)〕was significantly lower than that in control group〔30. 8%(4/13)〕(χ2 =9. 989,P=0. 001). After 12 months of follow-up,the survival rate in treatment group and in control group was 96. 9% and 53. 8%, respectively. After 36 months of follow-up,the survival rate in treatment group and in control group was 96. 9% and 30. 8%, respectively. There was significant difference in 36-month survival rate between treatment group and control group(χ2 =24. 06, P<0. 01). Conclusion The prognosis of TEVAR is significantly better than that of simple drug treatment.