腔内隔绝术治疗Debakey Ⅲ型主动脉夹层的临床效果  

Clinical effect of endovascular graft exclusion of aorta in treatment of type-Debakey Ⅲ aortic dissection

作　　者：丁红[1] 孙朝阳[1] 马翔[2] DING Hong;SUN Chao-yang;MA Xiang(Department o f Cardiovascular Diseases, Central Hospital o f Ankang City, Ankang 725000, China)

机构地区：[1]安康市中心医院心血管内科,安康725000 [2]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054

出　　处：《中国循证心血管医学杂志》2016年第11期1316-1318,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家自然科学基金(81000089)

摘　　要：目的总结Debakeym型主动脉夹层患者行主动脉腔内隔绝术（EVGA)治疗的手术效果。方法回顾性分析2012年6月~2015年1月于安康市中心医院采用EVGA治疗的39例Debakeym型主动脉夹层患者资料，男性34例，女性5例，年龄37~69岁，平均（55.0±10.4)岁。统计分析支架置人情况、手术情况。患者手术前后均接受CT血管造影（CTA)，对比各水平面（近端破口水平、膈肌水平、瘤体）的真假腔直径测定值变化情况。评价治疗效果，术后对患者进行随访，观察预后、内漏情况等。结果本组39例患者共置人支架42枚，其中3例患者置人2枚，支架长度范围40.0~200.0mm,平均（113.5±41.7)mm,支架直径范围26.0~42.0mm,平均（34.1±4.9)mm;手术时间2.7~4.8h,平均（3.1±0.7)h;术中出血量30~109ml,平均（67.4±28.1)ml;围手术期死亡1例。患者术后达到完全隔绝35例（89.74%)，3例出现内漏。术后，患者近端破口水平、膈肌水平、瘤体真腔直径测定值均显著大于术前，差异具有统计学意义（P均<〇.〇5)。近端破口水平、膈肌水平、瘤体假腔直径测定值均显著小于术前，差异具有统计学意义（P均<0.05)。结论Debakeym型主动脉夹层患者行EVGA治疗腔内隔绝效果可靠、安全性较高，值得临床推广应用。Objective To summarize the efficacy of endovascular graft exclusion of aorta(EVGA)in patientswith type-D ebakey m aortic dissection.Methods The materials of39patients(male34,female5,aged from37to69and average age=55.0±10.4)were retrospectively analyzed after EVGA in the Central Hospital of Ankang Cityfrom Jun.2012to Jan.2015.The situations of stenting and operation were analyzed.All patients were given CTangiography(CTA)before and after EVGA,and the measured value changes of true and false lumen diameters indifferent horizontal planes(proximal crevasse level,diaphragm level and tumor body)were compared.The curativeeffect was reviewed,and the patients were followed up after the operation.The prognosis and endoleak wereobserved.Results There were totally42stents implanted in39patients,and3patients with2stents.The range ofstent length was from40.0mm to200.0mm and average length was(113.5±41.7)mm.The range of stent diameterwas from26.0mm to42.0mm and average diam eter was(34.1±4.9)mm.The duration time of EVGA was from2.7h to4.8h and average time was(3.1±0.7)h,and bleeding volume was from30.0mL to109mL and averagevolume was(67.4±28.1)mL.There was one patients died during perioperative period.There were35patients(89.74%)achieved complete exclusion and3patients had endoleak after EVGA.The m easured values of truelumen diameters of proximal crevasse level,diaphragm level and tumor body were significantly higher after EVGA(allP<0.05).The measured values of false lumen diameters of proximal crevasse level,diaphragm level and tumor bodywere significantly lower after EVGA(all P<0.05).Conclusion The curative effect of EVGA is reliable and safe ontype-Debakey m aortic dissection,which is worth to be popularized and applied in clinic.

关 键 词：主动脉夹层 主动脉腔内隔绝术 支架 

分 类 号：R543.1[医药卫生—心血管疾病]