支架象鼻技术治疗胸主动脉夹层动脉瘤早中期效果Meta分析  

The early and mid-term result of the stented elephant trunk technique for the treatment of extensive thoracic aortic aneurysms:A Meta-Analysis

作　　者：李滨[1] 孙立忠[2] 赵鑫[1] 郑军[2] 常谦[1] 于存涛[1] 朱俊明[2] 刘永民[2] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院血管外科中心,北京100037 [2]北京首都医科大学安贞医院心外科,北京100029

出　　处：《山东大学学报（医学版）》2010年第6期92-95,99,共5页Journal of Shandong University:Health Sciences

基　　金：北京市科技计划资助项目(Z07050700690715)

摘　　要：目的通过Meta分析方法 ,对应用支架象鼻手术的早中期效果进行评估。方法通过检索Embase及Pubmed文献数据库,检索筛选获取2009年8月前发表的关于应用支架象鼻手术的12篇临床研究(538例患者)。结果支架象鼻手术后住院期间死亡率为(5.0±0.9)%;术后肾功能衰竭发生率(3.5±0.8)%;截瘫或者下肢轻瘫的发生率为(3.5±0.8)%;脑卒中的发生率为(2.9±0.7)%。总体平均随访(36.0±20.3)个月,中期生存率分别为1年(94.30±0.10)%;2年(93.60±0.11)%;5年(91.40±0.14)%。结论支架象鼻手术早中期能够降低手术死亡率及并发症的发生率,中期随访证实能够促使假腔内血栓的形成、封闭假腔。Objective To summarize studies on the stented elephant trunk procedure （SET） for extensive thoracic aortic aneurysms. Methods In this systematic review and Meta-analysis of all English language literature of SET through searches of the electronic databases EMBASE and Medline before August 2009,12 studies,involving a total of 538 patients,were included. Results Twenty-seven of 542 patients with available data died during the in-hospital period,yielding an overall in-hospital mortality rate of （5.0±0.9）%; the incidence of postoperative renal failure was （3.5±0.8）%; stroke occurred in （2.9±0.7）% of the patients; paraplegia or paraparesis was reported with an incidence of （3.5±0.8）%. Over a mean follow-up period of （36.0±20.3） months,the Kaplan-Meier analysis yielded overall survival rates of （94.30±0.10）% at year,（93.60±0.11）% at 2 years,and （91.40±0.14）% at years 5. Conclusions The SET technique represents an effective surgical option for the treatment of extensive aortic aneurysm with low early morbidity and mortality.Moreover,the efficacy in closing the residual false lumen of the descending aorea is proved in the middle-term.

关 键 词：支架象鼻术 主动脉瘤 主动脉夹层 

分 类 号：R654.1[医药卫生—外科学]