Stanford B型主动脉夹层52例报告  

The Treatment of Type B Aortic Dissection: a Report of 52 Cases

作　　者：蔡丽生[1] 蔡铭智[1] 陈秋贤[1] 林小雷[1] 徐立[1] 蔡明勇[1] 高金辉[1] 

机构地区：[1]福建医科大学附属漳州市医院普外科,漳州363000

出　　处：《中国微创外科杂志》2013年第10期899-902,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：福建医科大学漳州市医院院内基金项目(201201)

摘　　要：目的探讨StanfordB型主动脉夹层治疗的方案及经验教训。方法回顾性分析2008年6月～2013年4月52例StanfordB型主动脉夹层的临床资料。入院后给予卧床休息、降压、止痛等内科治疗，渡过急性期后行胸主动脉腔内修复术。结果39例成功渡过急性期，人院15～56d（中位数21d）行血管内覆膜支架置人术，均成功封堵破口，术后I型内漏3例，脑梗死2例（其中1例死亡）；7例未能渡过急性期破裂死亡；6例转院。结论急性期内科保守治疗及慢性期行带膜支架胸主动脉腔内修复术是治疗StanfordB型主动脉夹层的主要方案；稳定血压及患者的依从性是内科治疗成功的关键因素。Objective To explore the therapeutic effect through the experience of type B aortic dissection application. Methods Retrospective analysis was conducted on the data of 52 patients suffering from Stanford B aortic dissection. The patients were treated in our department from June 2008 to April 2013. Conservative treatments such as blood pressure control, analgesia and rest were carried out in all patients after being hospitalized, and thoracic endovascular aortic repair （TEVAR） was completed in 39 patients after the acute stage. Results Of the 52 cases, 39 patients underwent TEVAR successfully and the primary intimal tear was closed successfully. Type I endo-leak was found in 3 patients, and cerebral infarction occurred in 2 patients （1 patient died）. Seven patients died of aortic rupture before the operation and the other 6 patients were transferred to other hospital. Conclusions It was significant to provide conservative treatment during the acute stage and endovascular graft exclusion after the acute stage. Appropriate conservative treatment especially blood pressure control was the key measure during paraoperative treatment. The compliance of the patients was also very important.

关 键 词：主动脉夹层 支架 胸主动脉腔内修复术 

分 类 号：R654.3[医药卫生—外科学]