覆膜支架腔内修复治疗39例急性胸主动脉夹层的近期疗效观察  

Observation for short-term effect and safety of thoracic endovascular aortic repair for patients with complicated acute thoracic aortic dissection

作　　者：杨俊 代运国 孙向东 徐谭 杨贵宝 赵高阳 黄振文[2] 

机构地区：[1]河南省信阳市中心医院心内科,464000 [2]郑州大学第一附属医院心血管内科

出　　处：《中国实用医刊》2015年第5期52-55,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察覆膜支架腔内修复治疗复杂的急性胸主动脉夹层的近期疗效。方法选择2011年5月至2013年12月住院治疗复杂的急性胸主动脉夹层患者39例，所有入选者均为行腔内修复治疗的指征，其中31例患者行腔内修复治疗入选腔内修复治疗组，8例患者拒绝手术治疗入选对照组。详细记录临床特征、住院时间、死亡时间、住院费用，随访30d。结果覆膜支架治疗组手术均成功，围术期无严重并发症发生，随访期间无脑梗死、截瘫及肾功能衰竭等发生。对照组住院期间死亡3例，随访期间死亡1例。覆膜支架治疗组14d及30d生存率分别为100％和100％，显著高于对照组的62．5％和50．0％（P均〈0．01），且覆膜支架治疗组患者的住院时间显著低于对照组（P〈0．05）。结论覆膜支架治疗复杂的急性胸主动脉夹层疗效确切，具有创伤小、疗效好、并发症少、预后好等优点。Objective To evaluate the short-term efficiancy and safety of thoracic endovascular aortic repair（TEVAR） in patients with complicated acute thoracic aortic dissection（AAD）. Methods From May 2011 to December 2013, thirty-nine patients who were diagnosed as complicated acute thoracic aortic dissection were enrolled. All patients were admitted in intensive care unit immediately when they were diagnosed as acute thoracic aortic dissection and the blood pressure, heart rate, oxygen saturation of blood and urine output were monitored. They also had symptoms of development of dissection and were suitable for endovaseular repair. Thirty-one of them in treatment group agreed to the operation of endovascular repair, and the rest 8 in control group refused to operation. The clinic symptom, complications, survival time, ere, were recorded and followed 30 days after the onset of the thoracic aortic dissection. Results No patient died in the operation of endovascular aortic repair and in our follow-up period in endovascular aortic repair group. While 3 patients of control group died inpatient period in control group, what＇ s more, 1 patient died during the follow up. The survival rate of endovascular aortic repair group in 14 day and 30 day in treatment group（both were 100% ） was higher than that of the control group, which were 62.5% and 50.0% respectively （P 〈 0. 01 respectively） , and the differences were significant（P 〈 0.01 ）. The time of staying hospital in treatment group was also significantly lower than that of control group （ P 〈 0.05 ）. Conclusions The short-term effieianey and safety of endovascular repair treatment for complicated acute aortic dissection was very well, it has the advantages of little cut, better effect, lower complications, better prognosis than control group, so it should be generalized.

关 键 词：腔内修复治疗 胸主动脉夹层 支架 预后 

分 类 号：R543.1[医药卫生—心血管疾病]