胸主动脉腔内修复术在复杂型与非复杂型B型主动脉夹层患者中应用的效果对比  

Comparison of the effects of thoracic aortic endovascular repair in patients with complicated and uncomplicated type B aortic dissection

作　　者：张友聪 高慧强[1] 任长伟[1] 阳晟[1] 金秀峰[1] 周坤[1] 郑军[1] 孙立忠[1] 许尚栋[1] ZHANG Youcong;GAO Huiqiang;REN Changwei;YANG Sheng;JIN Xiufeng;ZHOU Kun;ZHENG Jun;SUN Lizhong;XU Shangdong(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capita Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心脏外科,100029

出　　处：《心肺血管病杂志》2020年第6期706-710,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:对比胸主动脉腔内修复术(TEVAR)在复杂与非复杂型B型主动脉夹层患者中应用的效果。方法:收集自2013年1月至2015年3月,在北京安贞医院就诊并行TEVAR术治疗的B型主动脉夹层患者资料用于分析。结果:共有226例患者符合入选标准,中位随访时间25个月(6~38个月),其中非复杂型B型夹层患者197例;围术期死亡1例,随访期间死亡4例,3例分别因I型内漏、逆行性A型夹层、支架远端新发破口再次行手术治疗;术后3年生存率为98.1%。复杂型B型夹层患者29例;围术期死亡2例,随访期间死亡1例,1例因支架远端新发破口再次行手术治疗;术后3年生存率为96.3%。结论:TEVAR术能够使复杂型B型夹层患者获得与非复杂型患者相似的3年生存率,但在复杂型B型主动脉夹层患者中围术期并发证发生率较高。Objective:To compare the effects of thoracic aortic endovascular repair(TEVAR)in patients with complicated and uncomplicated type B aortic dissection.Methods:From January 2013 to March 2015,the Medical and followed-up data of patients with type B aortic dissection who were treated with TEVAR in Beijing Anzhen Hospital were collected for analysis.Results:There are 226 patients met the inclusion criteria and the median follow-up time was 25 months(6-38 months).Including 197 patients with uncomplicated type B aortic dissection.Among these patients,25%and 75%quartiles from onset to surgery time were 8.2 days and 22 days,1 patient died during the perioperative period,4 patients died during the follow-up period,and 3 patients underwent surgery again due to type I endoleak,retrograde A dissection and new rupture at the distal end of the stent.The 3-year survival rate after surgery was 98.1%.Another 29 patients were complicated type B aortic dissection.Among these patients,25%and 75%quartiles from onset to surgery time were 9 days and 33 days,2 patient died during the perioperative period,1 patients died during the follow-up period,and 1 patients underwent surgery again due to new rupture at the distal end of the stent.The 3-year survival rate after surgery was 96.3%.Conliusions:TEVAR can make patients with complicated type B dissection have a similar 3-year survival rate as uncomplicated patients,but the incidence of perioperative complications is higher in patients with complex type B aortic dissection.

关 键 词：胸主动脉腔内修复术 复杂B型主动脉夹层 非复杂B型主动脉夹层 

分 类 号：R54[医药卫生—心血管疾病]