不同支架应用方式对肠系膜上动脉夹层动脉瘤患者的作用及预后对比分析  

Comparative analysis of the effect and prognosis of patients with superior mesenteric artery dissecting aneurysm by different stent application methods

作　　者：林继平[1] 肖亦明[1] 唐承富[1] 谭志斌[1] 范惠双[1] LIN Jiping;XIAO Yiming;TANG Chengfu;TAN Zhibin;FAN Huishuang(Department of Intervention,Dongguan People′s Hospital,Dongguan 523018,China)

机构地区：[1]广东东莞市人民医院介入科,523018

出　　处：《心肺血管病杂志》2020年第4期436-439,444,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究对比差异性支架应用方式对肠系膜上动脉夹层动脉瘤患者的作用及预后。方法:将从2012年1月至2018年1月期间,我院收治的60例肠系膜上动脉夹层动脉瘤患者作为研究对象。将其按照治疗方式的不同分为观察组28例与对照组32例。观察组采用覆膜支架血管腔内隔绝术治疗,对照组则采用裸支架血管腔内隔绝术治疗。分别比较两组各项手术指标(主要包括手术时间、术后重症监护停留时间、住院时间)水平,术后并发症控制效果,二期手术率、复发率以及术后28 d病死率。结果:观察组手术时间、术后重症监护停留时间、住院时间均低于对照组(均P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。观察组二期手术率低于对照组(P<0.05);而观察组与对照组在复发率以及术后28 d病死率方面对比不明显(均P>0.05)。结论:覆膜支架血管腔内隔绝术应用于肠系膜上动脉夹层动脉瘤患者中的作用显著,有利于促进患者的早日康复,降低术后并发症发生风险以及二期手术率,且不会增加术后复发率与病死率,预后较佳,值得临床推广应用。Objective:To study and analyze the effect and prognosis of patients with superior mesenteric artery dissecting aneurysm by comparing different stent application method.Methods:60 patients with superior mesenteric artery dissection aneurysm admitted to our hospital from January 2012 to January 2018 were selected as research objects.They were divided into 28 cases in the study group and 32 cases in the control group according to the different treatment method.The study group was treated with endovascular stent graft,while the control group was treated with endovascular stent graft.The operative indexes(including operation time,stay in intensive care after operation,length of stay in hospital),postoperative complication control effect,second-stage operation rate,recurrence rate and postoperative mortality rate were compared in the two groups.Results:The duration of operation,duration of stay in intensive care and length of stay in hospital were lower in the study group than in the control group(all P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group(P<0.05).The second-stage operation rate of the study group was lower than that of the control group(P<0.05).However,the comparison between the study group and the control group was not significant in recurrence rate and postoperative mortality on 28 days(all P>0.05).Conclusions:Endovascular stent graft has a significant effect on patients with superior mesenteric artery dissection aneurysms,which is conducive to promoting the early recovery of patients,reducing the risk of postoperative complications and the rate of secondary surgery,and does not increase the postoperative recurrence rate and mortality rate,with a good prognosis.It is worthy of clinical application.

关 键 词：肠系膜上动脉夹层动脉瘤 覆膜支架血管腔内隔绝术 裸支架血管腔内隔绝术 并发症 预后 

分 类 号：R54[医药卫生—心血管疾病]