CAJ | 학술논문

目的总结主动脉腔内修复术治疗经验.方法 2008年10月至2013年8月,101例患者行主动脉腔内修复术(TEVAR),男81例,女20例.术前均行胸腹主动脉CT血管造影(CTA)检查,Stanford B型主动脉夹层86例,主动脉严重穿透性溃疡10例,外伤性降主动脉疾病5例.TEVAR术后1周、3个月、半年及以后每年复查1次胸腹主动脉CTA,观察术后并发症、疗效、支架形态和自身血管情况.结果 101例患者中,单纯TEVAR 90例(89.11％),头臂血管转流11例(10.89％).术后应用腰大池引流3例(2.97％),Ⅰ型内漏1例(0.99％),严重应激性溃疡1例(0.99％).死亡2例(1.98％),其中1例术后合并截瘫、急性肾功能衰竭、卒中、下肢动脉栓塞,终死于主动脉夹层破裂.结论 TEVAR优势明显,围手术期的风险和并发症发生低,但需严格控制手术指征,保证患者脑血管供血.
목적 총결주동맥강내수복술치료경험.방법 2008년10월지2013년8월,101례환자행주동맥강내수복술(TEVAR),남81례,녀20례.술전균행흉복주동맥CT혈관조영(CTA)검사,Stanford B형주동맥협층86례,주동맥엄중천투성궤양10례,외상성강주동맥질병5례.TEVAR술후1주、3개월、반년급이후매년복사1차흉복주동맥CTA,관찰술후병발증、료효、지가형태화자신혈관정황.결과 101례환자중,단순TEVAR 90례(89.11％),두비혈관전류11례(10.89％).술후응용요대지인류3례(2.97％),Ⅰ형내루1례(0.99％),엄중응격성궤양1례(0.99％).사망2례(1.98％),기중1례술후합병절탄、급성신공능쇠갈、졸중、하지동맥전새,종사우주동맥협층파렬.결론 TEVAR우세명현,위수술기적풍험화병발증발생저,단수엄격공제수술지정,보증환자뇌혈관공혈.
Objective To summarize the clinical experience and significance of 101 cases of thoracic endovascular aortic repair(TEVAR).Methods From October 2008 to August 2013,101 patients received endovascular repair.Among the cases,81 patients were male,and 20 were female.Before operation,all patients underwent thoracoabdominal aortic CTA examination,there were 5 cases of traumatic aortic diseases,10 cases of severe aortic penetrating ulcer,86 cases of Stanford type B aortic dissection.All patients follow up with CTA 1 weeks,3 months,half a year,and annually postoperatively.Postoperative complications,efficacy,morphology and its vascular stent were observed.Results All cases received TEVAR,there were 90 cases of simple repair of aortic lumen (89.11％),11 cases of brachiocephalic vessels bypass (10.89％),2 cases of death (1.98％),1 case of type Ⅰ endoleak(0.99％),3 cases of the application of lumbar cistern drainage(2.97％),1 case of severe stress ulcer(0.99％),1 patient died after surgery with paraplegia,acute renal failure,stroke,lower limb artery embolization,dissection rupture.Conclusion Thoracic endovascular aortic repair has obvious advantage,risks and complications incidence of preoperative period is low,the technology is worth popularizing widely,but needed to pay attention to strictly control the indications of operation and ensure the brain blood supply.