Stanford B型主动脉夹层腔内修复术后死亡原因分析  

Analysis of the causes of death in patients with Stanford type B aortic dissection after endovascular repair

作　　者：王国权[1] 翟水亭[1] 李天晓[1] 逯党辉 王博[1] 张东宾[1] 史帅涛[1] 张志东[1] 梁凯[1] 符晓阳[1] 张克伟[1] 李坤[1] 李卫校[1] 陈瑞阳[1] 

机构地区：[1]河南省人民医院(郑州大学人民医院)血管外科,郑州450003

出　　处：《介入放射学杂志》2015年第11期950-953,共4页Journal of Interventional Radiology

摘　　要：目的 分析胸主动脉腔内修复术（TEVAR）治疗Stanford B型主动脉夹层后患者死亡及其原因。方法 2004年2月至2014年12月,462例复杂性Stanford B型主动脉夹层患者在河南省人民医院接受TEVAR术治疗,其中男387例,女75例,平均（53.3±13.5）岁（18-89岁）。统计TEVAR术后患者死亡情况,并分析可能的致死原因。结果 TEVAR术后患者死亡7例（7/462,1.52%）,其中男性5例,女性2例。可能的致死原因：夹层破裂3例（3/462,0.65%）,肠道缺血2例（2/462,0.43%）,呼吸功能衰竭1例（1/462,0.22%）,心源性猝死1例（1/462,0.22%）。结论 TEVAR术治疗复杂性Stanford B型主动脉夹层安全有效,术后住院病死率较低。夹层破裂和肠道缺血为主要致死原因,值得临床关注。Objective To analyze the causes of death in patients with Stanford type B aortic dissection after thoracic endovascular aortic repair （TEVAR）. Methods During the period from February 2004 to December 2014, a total of 462 patients with complex symptomatic Stanford type B aortic dissection underwent TEVAR at Henan Provincial People＇s Hospital. The patients included 387 males and 75 females with a mean age of （53.3±13.5） years old （range 18-89 years）. The occurrence of death after TEVAR was calculated, and the possible causes for death were discussed. Results After TEVAR death occurred in seven patients （7/462,1.52%）, including 5 males and 2 females. The possible causes of death included rupture of dissection （3/462,0.65%）, intestinal isehemia （2/462,0.43%）, respiratory failure （1/462,0.22%） and cardiac sudden death （1/462, 0.22%）. Conclusion For the treatment of complex Stanford type B aortic dissection, TEVAR is safe and effective; and the postoperative hospitalization mortality is lower. The main causes of death are rupture of dissection and intestinal ischemia, which is worthy of clinical attention.

关 键 词：STANFORD B型主动脉夹层 胸主动脉腔内修复术 围手术期 死亡原因 

分 类 号：R654.3[医药卫生—外科学]