急性Standford B型主动脉夹层并胸腔积液患者的治疗探讨  

Discussion on the treatment of acute Standford type B aortic dissection complicated by massive hydrothorax

作　　者：白斗[1] 蒋岚杉[1] 刘启榆[2] 杨勇[2] 张效杰[1] 武少辉 

机构地区：[1]绵阳市中心医院血管外科,四川绵阳621000 [2]绵阳市中心医院放射科,四川绵阳621000

出　　处：《介入放射学杂志》2013年第10期848-850,共3页Journal of Interventional Radiology

摘　　要：目的探讨胸主动脉夹层动脉瘤(TAD)Stanford B型并胸腔积液患者术后行胸腔穿刺引流治疗的价值。方法对2005年10月至2012年6月共29例Stanford B型TAD并胸腔积液患者行覆膜支架腔内隔绝术(EVGE)治疗后,对其胸腔积液是否行置管引流术进行比较。结果是否引流两组比较患者胸闷、气紧症状改善明显(P=0.01),差异有统计学意义(P≤0.01)。引流组同未引流组就术后肺部感染率比较引流组明显低于未引流组,差异有统计学意义。结论 TAD并胸腔积液患者术后行胸腔积液引流术能明显缩短胸闷、气紧等症状的时间,有利于患者术后的早期活动。同时能缩短患者住院时间,降低患者住院费用,对患者胸腔积液早期治疗性干预有临床及经济价值,因此TAD并胸腔积液患者应及早行干预治疗。Objective T0 discuss the therapeutic value of thoracic puncture drainage in treating patients of aortic dissection of Stanford type B associated with pleural effusion atier the operation of endovascular graft exclusion. Methods A total of 29 patients of aortic dissection of Stanford type B associated with pleural effusion, who were encountered at authors＇ hospital during the period from Oct. 2005 to June 2012, were enrolled in this study. Endovascular graft exclusion was carried out in all patients. Twenty-seven patients survived the operation. Then the patients were divided into two groups. Patients in the study group （n = 14） received thoracic puncture drainage, while patients in the control group （n = 13） did not receive thoracic puncture drainage. The clinical results were compared between the two groups. Results After the treatment, the improvement of chest stress amt short breath in patients of study group was much more significant than that in patients of control group, and the difference was statistically significant （P = 0.0l ）, while postoperative pulmonmy infection incidence in patients of study grnup was significantly lower than that in patients of control group （P 〈 0.05）. Conclusion The postoperative thoracic puncture drainage can rapidly and markedly improve the chest stress and short breath in patients of aortic dissection of Stanford type B associated with pleural effusion, which is favorable for the patients to make physical exertion early. Meanwhile, the hospitalization days can also be shortened, and the medical cost is reduced. Early therapeutic intervention to treat pleural effusion has both clinical and econonfical value. Therefore, for patients of aortic dissection of Stanford type B associated with pleural effusion intervention therapy should be carried out as early as possible.（J lntervent Radiol. 2013, 22： 848-850）

关 键 词：胸主动脉夹层动脉瘤 胸腔积液 

分 类 号：R543.1[医药卫生—心血管疾病]