胸主动脉夹层动脉瘤腔内修复术联合药物对稳定型B型主动脉夹层患者疗效及安全性研究  

Efficacy and Safety of Thoracic Endovascular Aortic Repair combined with Drug in Patients with Stanford B Type Aortic Dissection

作　　者：管军[1] 曾骞[1] 邓超[1] GUAN Jun;ZENG Qian;DENG Chao(Haikou People's Hospital,Hainan Haikou 570208,China)

机构地区：[1]海南省海口市人民医院

出　　处：《河北医学》2019年第11期1858-1861,共4页Hebei Medicine

基　　金：海南省海口市重点科技计划项目,(编号:2012-068)

摘　　要：目的:研究胸主动脉夹层动脉瘤腔内修复术(TEVAR)联合药物与单纯药物治疗对稳定性B型主动脉夹层(Stanford B型AD)患者疗效及安全性。方法:回顾性分析我院2011年1月至2015年1月收治的86例Stanford B型AD患者临床资料,根据治疗手段将其分为联合组(TEVAR+药物治疗,n=56)与药物组(单纯药物治疗,n=30),观察两组治疗效果。结果:联合组患者手术技术成功率为100%;两组住院期间各类并发症无显著性差异(P>0.05);两组患者住院期间病死率无显著性差异(P>0.05);术后随访12~48个月,两组病死率、主要并发症及真腔最大直径无显著性差异(P>0.05),而联合组患者血栓形成率及血栓吸收率均显著高于药物组,假腔最大直径显著小于药物组(P<0.05);药物组及联合组患者中位生存时间均为48个月,Log Rank检验提示两组生存率无显著性差异(χ^2=0.50,P>0.05)。结论:TEVAR联合药物治疗能有效提高稳定型B型主动脉夹层患者血栓形成率及血栓吸收率,缩小假腔最大直径,但术后并发症较多,并不能有效延长患者生存时间。Objective:To study the efficacy and safety of thoracic endovascular aortic repair(TEVAR)combined with drug and absolute drug therapy in patients with Stanford B type aortic dissection(Stanford B type AD).Methods:The clinical data of 86 patients with Stanford B type AD admitted to our hospital from2010.01 to 2015.01 were retrospectively analyzed.According to the treatment methods,they were divided into combined group(TEVAR+drug therapy,n=56)and drug group(pure drug therapy,n=30).The treatment effects were observed in the two groups.Results:The success rate of surgical technique was 100%in combined group.There were no significant differences in the various complications during hospitalization between the two groups(P>0.05).There was no significant difference infatality rate during hospitalization(P>0.05).At 12~48 months of follow-up after operation,there were no significant differences in the fatality rate,major complications and maximum diameter of true lumen between the two groups(P>0.05),and the thrombosis formation rate and thrombus absorption rate in combined group were significantly higher than those in drug group(P>0.05),and the maximum diameter of false lumen was significantly less than that in drug group(P<0.05).The median survival time in drug group and combined group both were 48 months,and the Log Rank test showed there was no significant difference in survival rate between the two groups(χ^2=0.50,P>0.05).Conclusion:TEVAR combined with drug therapy can effectively improve the thrombosis formation rate and thrombus absorption rate in patients with Stanford B type aortic dissection,and reduce the maximum diameter of false lumen.However,it has more postoperative complications and can not effectively extend the survival time of patients.

关 键 词：稳定型B型主动脉夹层 胸主动脉夹层动脉瘤腔内修复术 药物治疗 

分 类 号：R65[医药卫生—外科学]