天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
6期
649-652
,共4页
主动脉疾病%支架%手术后并发症%Stanford B型主动脉夹层%胸主动脉覆膜支架隔绝术
主動脈疾病%支架%手術後併髮癥%Stanford B型主動脈夾層%胸主動脈覆膜支架隔絕術
주동맥질병%지가%수술후병발증%Stanford B형주동맥협층%흉주동맥복막지가격절술
aortic diseases%stents%postoperative complications%Stanford type B aortic dissection%TEVAR
目的：探讨Stanford B型主动脉夹层适宜的治疗方案。方法回顾性分析天津医科大学总医院2008年5月—2013年3月51例Stanford B型主动脉夹层患者临床资料，并通过回访评价患者生存及康复情况。依照是否行胸主动脉覆膜支架隔绝术（TEVAR），分为支架组40例及保守组11例。结果40例患者TEVAR手术全部成功，围手术期死亡2例（5%），随访期间无死亡患者；11例保守治疗患者院内死亡1例（9.1%），随访期间死亡7例（63.6%）。K-M生存曲线分析显示支架组2年生存率明显高于保守组。支架组术后主动脉及假腔最大直径呈减小趋势且假腔血栓化。结论对于Stanford B型主动脉夹层患者，TEVAR治疗成功率高，促进主动脉真假腔重塑，相对传统内科保守治疗可以显著提高患者生存率、近中期效果好。
目的：探討Stanford B型主動脈夾層適宜的治療方案。方法迴顧性分析天津醫科大學總醫院2008年5月—2013年3月51例Stanford B型主動脈夾層患者臨床資料，併通過迴訪評價患者生存及康複情況。依照是否行胸主動脈覆膜支架隔絕術（TEVAR），分為支架組40例及保守組11例。結果40例患者TEVAR手術全部成功，圍手術期死亡2例（5%），隨訪期間無死亡患者；11例保守治療患者院內死亡1例（9.1%），隨訪期間死亡7例（63.6%）。K-M生存麯線分析顯示支架組2年生存率明顯高于保守組。支架組術後主動脈及假腔最大直徑呈減小趨勢且假腔血栓化。結論對于Stanford B型主動脈夾層患者，TEVAR治療成功率高，促進主動脈真假腔重塑，相對傳統內科保守治療可以顯著提高患者生存率、近中期效果好。
목적：탐토Stanford B형주동맥협층괄의적치료방안。방법회고성분석천진의과대학총의원2008년5월—2013년3월51례Stanford B형주동맥협층환자림상자료，병통과회방평개환자생존급강복정황。의조시부행흉주동맥복막지가격절술（TEVAR），분위지가조40례급보수조11례。결과40례환자TEVAR수술전부성공，위수술기사망2례（5%），수방기간무사망환자；11례보수치료환자원내사망1례（9.1%），수방기간사망7례（63.6%）。K-M생존곡선분석현시지가조2년생존솔명현고우보수조。지가조술후주동맥급가강최대직경정감소추세차가강혈전화。결론대우Stanford B형주동맥협층환자，TEVAR치료성공솔고，촉진주동맥진가강중소，상대전통내과보수치료가이현저제고환자생존솔、근중기효과호。
Objective To explore the optimal treatment options of Stanford type B aortic dissection. Methods A to?tal of 51 patients with Stanford type B aortic dissection who visited the General Hospital of Tianjin Medical University from May 2008 to March 2013 were analyzed retrospectively. Survival and recovery of patients were evaluated by follow ups. Pa?tients were divided to TEVAR group(40 cases)and conservative group(11 cases)according to the treatment they recieved. Results Operations were successful in all 40 patients. There were two cases of perioperative death(5%). And none of pa?tients died in TEVAR group during follow-up. One case among 11 patients who received conservative treatment dead in hos?pital(9.1%)while other 7 cases died during follow-up(63.6%). Kaplan-Meier survival curve showed that two-year survival rate of TEVAR group was significantly higher than that of conservative group. In TEVAR group, the maximum diameter of the aorta presented a decreasing trend and thrombosis was seen in artificial lumen with time going after operation. Conclu?sion For patients with Stanford type B aortic dissection, TEVAR presented a high success rate and promoted remodeling of the aortic genuine and aritificial lumen. What’s more, it can significantly improve patient’s survival rate and recovery in short or mid-term period compared with effect of traditional conservative treatment.
