预置血管缝合器行B型主动脉夹层腔内隔绝术的疗效观察  

Efficacy observation of using preclose technique in endovascular exclusion of type B aortic dissection

作　　者：陈卢峰[1] 蔡旭东[1] 

机构地区：[1]福建医科大学附属第二医院胸心血管外科,福建泉州362000

出　　处：《中国普通外科杂志》2017年第12期1562-1567,共6页China Journal of General Surgery

基　　金：福建省中青年教师教育科研基金资助项目(JAT160215)

摘　　要：目的:探讨预置血管缝合器行B型主动脉夹层腔内隔绝术的疗效。方法:将收治的109例B型主动脉夹层患者分为观察组(55例)和对照组(54例),观察组患者采取预置2把Pro Gilde血管缝合器进行术后修复穿刺点,对照组采取传统缝合修复的方法,比较两组患者的相关临床指标。结果:与对照组比较,观察组平均手术时间(98.2 min vs.140.8 min)、退鞘后血管处理时间(4.3 min vs.9.1 min)、住院时间(4.4 d vs.5.9 d)的均明显减少,平均住院费用(8.4万元vs.8.1万元)增加(均P<0.05),而下肢制动时间无明显差异(P>0.05);观察组与对照组的手术成功率、术后3个月手术部位的血管直径差异均无统计学意义(均P>0.05);观察组1例、对照组3例因发生内漏实施二次手术,观察组的总并发症发生率明显低于对照组(7.27%vs.24.07%,P<0.05)。结论:预置血管缝合器行B型主动脉夹层腔内隔绝术安全高效、手术效果可靠、且术后并发症少。Objective： To investigate the efficacy of using preclose technique in endovascular exclusion of type B aortic dissection. Methods： One-hundred and nine patients with type B aortic dissection were designated to observation group （55 cases） and control group （54 cases）. Patients in observation group received preplaced two ProGilde devices for vascular access site repair, and those in control group received the traditional repair method. The main clinical variables between the two groups of patients were compared. Results： In observation group compared with control group, the average operative time （98.2 minvs. 140.8 min）, time to achieve hemostasis after sheath pulling （4.3 minvs. 9.1 min） and length of hospital stay （4.4 dvs. 5.9 d） were significantly reduced, and hospitalization cost （84000 yuanvs. 81000 yuan） was significantly increased （all P〈0.05）, while the duration of immobilization of the lower limb showed no significant diffierence （P〉0.05）. The surgical success rates and blood vessel diameters at the surgical site 3 months after operation showed no significant differences between the two groups （both P〉0.05）. One case in observation group and 3 cases in control group underwent repeat intervention due to apparent endoleak, and the overall incidence of complications in observation group was significantly lower than that in control group （7.27%vs. 24.07%,P〈0.05）. Conclusion： Using preclose technique in endovascular exclusion of type B aortic dissection is safe and efficient, with reliable surgical results and few postoperative complications.

关 键 词：动脉瘤 夹层 血管内操作 伤口缝合技术 

分 类 号：R654.3[医药卫生—外科学]