腔内隔绝术治疗主动脉夹层(Stanford B型)254例临床分析  

The Clinical Analysis of Endovascular Graft Exclusion in Treatment of Aortic Dissection(Standard B)

作　　者：刘训强[1] 陈宦君[1] 刘斌[1] 田民[1] 毛志坚[1] 张金辉[1] 

机构地区：[1]昆明医科大学附属延安医院血管外科,云南昆明650051

出　　处：《昆明医科大学学报》2015年第8期53-56,共4页Journal of Kunming Medical University

基　　金：云南省科技厅科技惠民专项基金资助项目(2014RA071)

摘　　要：目的探讨腔内隔绝术治疗主动脉夹层（Stanford B型）的临床经验.方法回顾性分析2005年6月至2014年11月昆明医科大学附属延安医院血管介入科实施腔内隔绝术治疗主动脉夹层（Stanford B型）254例的治疗效果.结果 254例患者中253例成功植入覆膜支架,成功率99.6%,1例因降主动脉迂曲未成功置入覆膜支架,术中置入1个覆膜支架229例,置入2个覆膜支架24例,覆膜支架远端先置入限制性裸支架38例,术中左锁骨下动脉置入烟囱支架32例,术后左锁骨下动脉置入烟囱支架6例,手术时间30-108 min,平均48min,术中出血10-50 m L,平均20 m L,253例手术均顺利完成并安全返回病房,术后4 d死亡1例,其余均好转出院,术后随访232例2-48个月,23例死亡（其中包括置入支架不成功1例）,其余均健在.结论腔内隔绝术治疗主动脉夹层（Stanford B型）具有疗效确切、微创、操作简便、安全、减轻患者的痛苦、缩短手术时间、降低死亡率、并发症少、术后恢复快等优势,近期、中期疗效较好,远期疗效仍有待观察,尤其适用于急性主动脉夹层（Stanford B型）患者.Objective To explore the clinical experiences in treatment of aortic dissection（Stanford type B）with endovascular Graft Exclusion.Method We retrospectively analyzed Endovascular Graft Exclusion in treatment of 254 patients with aortic dissection in the affiliated Yan＇an Hospital of Kunming Medical University from June 2006 to November 2014,and shared our clinical experience in treatment.Results In 254 patients, 253 cases were successfully implanted coated stents, Success rate was 99.6%, 1 case due to the descending aorta circuity failed in coated stents,Intraoperative placement 1 coated stents in 229 cases,25 cases into two coated stents, coated stents distal placing restrictive naked first 38 cases,surgery left subclavian artery in 42 cases of chimney stents,postoperative left subclavian artery 6 cases in chimney stents,Operation time is from 30 min to 108 min, the average 48 min,intraoperative bleeding 10-50 m L,an average 20 m L,253 operations are completed smoothly and safely back ward, died four days after surgery in 1 case,the rest were all improved,postoperative follow- up of 232 cases was for 2 - 48 months,23 cases of death（Including placing stents not succeed in 1 case）,the remaining patients were alive.Conclusion Endovascular Graft Exclusion in treatment of aortic dissection（Stanford type B） is definite ly effective, minimally invasive, simple, safe, and can ease the pain of the patients,shorten the operation time,reduce the mortality rate,and has less complications,fast recovery of therecent, better medium- term curative effect, but the long- term curative effect remains to be seen, especially suitable for acute aortic dissection（Stanford type B） patients.

关 键 词：腔内隔绝术 主动脉夹层(Stanford B型) 分析 

分 类 号：R654.3[医药卫生—外科学]