中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
9期
539-542
,共4页
郭曦%黄小勇%李彭%薛玉国%刘光锐%韩晓峰%陈菲%任长伟%许尚栋
郭晞%黃小勇%李彭%薛玉國%劉光銳%韓曉峰%陳菲%任長偉%許尚棟
곽희%황소용%리팽%설옥국%류광예%한효봉%진비%임장위%허상동
胸主动脉疾病%覆膜支架修复术%主动脉夹层%胸主动脉瘤%脊髓缺血%截瘫
胸主動脈疾病%覆膜支架脩複術%主動脈夾層%胸主動脈瘤%脊髓缺血%截癱
흉주동맥질병%복막지가수복술%주동맥협층%흉주동맥류%척수결혈%절탄
Repair of thoracic aortic disease%Stent%Aortic dissection%Penetrating atherosclerotic ulcer%Descending aortic aneurysm%Spinal cord ischemia
目的 探讨累及膈下(T8)乃至腰椎水平的胸主动脉疾病患者行选择性胸主动脉覆膜支架腔内修复术覆盖全降主动脉后的脊髓局部缺血情况.方法 回顾性分析2009年2月至2013年3月收治的78例病变累及膈水平以下(T8)的胸主动脉疾病患者资料,其中男72例,女6例;年龄36～ 82岁,平均(58.46 ±8.37)岁.主动脉夹层41例,主动脉穿通性溃疡14例,主动脉瘤19例,主动脉二次支架置入4例.采用开放性游离一侧股动脉或选择性穿刺预埋Perclose ProGildTM两种方式,完成主动脉腔内修复术,依据病情选择长230 mm的支架或置入2枚覆膜支架(部分重叠),累计长度(244.74±18.67)mm.结果 术后脊髓损伤3例(3.8％),经脱水及神经营养性治疗后痊愈.随访3～24个月,所有患者未出现支架内漏和支架移位等并发症.结论 应用长支架覆盖全降主动脉处理病变范围累及T8水平以下的病变,会引起脊髓缺血,应有效预防和及时处理.
目的 探討纍及膈下(T8)迺至腰椎水平的胸主動脈疾病患者行選擇性胸主動脈覆膜支架腔內脩複術覆蓋全降主動脈後的脊髓跼部缺血情況.方法 迴顧性分析2009年2月至2013年3月收治的78例病變纍及膈水平以下(T8)的胸主動脈疾病患者資料,其中男72例,女6例;年齡36～ 82歲,平均(58.46 ±8.37)歲.主動脈夾層41例,主動脈穿通性潰瘍14例,主動脈瘤19例,主動脈二次支架置入4例.採用開放性遊離一側股動脈或選擇性穿刺預埋Perclose ProGildTM兩種方式,完成主動脈腔內脩複術,依據病情選擇長230 mm的支架或置入2枚覆膜支架(部分重疊),纍計長度(244.74±18.67)mm.結果 術後脊髓損傷3例(3.8％),經脫水及神經營養性治療後痊愈.隨訪3～24箇月,所有患者未齣現支架內漏和支架移位等併髮癥.結論 應用長支架覆蓋全降主動脈處理病變範圍纍及T8水平以下的病變,會引起脊髓缺血,應有效預防和及時處理.
목적 탐토루급격하(T8)내지요추수평적흉주동맥질병환자행선택성흉주동맥복막지가강내수복술복개전강주동맥후적척수국부결혈정황.방법 회고성분석2009년2월지2013년3월수치적78례병변루급격수평이하(T8)적흉주동맥질병환자자료,기중남72례,녀6례;년령36～ 82세,평균(58.46 ±8.37)세.주동맥협층41례,주동맥천통성궤양14례,주동맥류19례,주동맥이차지가치입4례.채용개방성유리일측고동맥혹선택성천자예매Perclose ProGildTM량충방식,완성주동맥강내수복술,의거병정선택장230 mm적지가혹치입2매복막지가(부분중첩),루계장도(244.74±18.67)mm.결과 술후척수손상3례(3.8％),경탈수급신경영양성치료후전유.수방3～24개월,소유환자미출현지가내루화지가이위등병발증.결론 응용장지가복개전강주동맥처리병변범위루급T8수평이하적병변,회인기척수결혈,응유효예방화급시처리.
Objective To discuss the lesions larger thoracic aortic diseases involving the lumbar level of selective thoracic aortic stent-graft repair after spinal cord ischemia.Methods From February 2009 to March 2013,the retrospective analysis in the center hospitalized involving the diaphragm below the level(Ts) range of the thoracic aorta in patients,a total of 78 cases,72 male and 6 female,average age (58.46 ± 8.37) years.There were 41 cases in AD,14 cases in PAU,19 cases in TAA,and 4 cases in redo.The open side of femoral artery puncture or selective embedded Perclose ProGild,completion of endovascular repair of aortic stent,which according to disease,length of stent 230 mm or implantation of 2 covered stent,overlapping.Results 3 cases (3.8％) of spinal cord injury,the nutrition of the dewatering machine nerve recovery after treatment,the average follow-up of 3-24 months,all patients no stent leakage and stent displacement complications.Conclusion The the curative effect is satisfied that the treatment for lesion involve the inferior level of Ts with long stent to covered the whole descend aorta.Although avoiding the paraplegia completely is impossible.The effective prevention and treatment is important.
