DeBakey Ⅲ型主动脉夹层腔内隔绝术后远端主动脉重建影响因素分析  

Influencing factors of distal aortic remodeling after endovascular exclusion of DeBakey typeⅢaortic dissecting

作　　者：马伟[1] 武建英[1] 芦广顺 丛萌倩 李晓君 钟浩[1] MA Wei;WU Jian-ying;LU Guang-shun;CONG Meng-qian;LI Xiao-jun;ZHONG Hao(Department of Cardiovascular Surgery,Qinghai University Affiliated Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海大学附属医院心血管外科,青海西宁810000

出　　处：《岭南心血管病杂志》2020年第4期420-423,共4页South China Journal of Cardiovascular Diseases

基　　金：青海大学附属医院中青年科研基金项目(项目编号:ASRF-2019-YB-03)。

摘　　要：目的应用计算机断层扫描及影像分析软件评估血流动力学因素对DeBakeyⅢ型主动脉夹层腔内隔绝术后远端主动脉重建的影响及预后。方法回顾性分析2014年1月至2018年8月于青海大学附属医院接受主动脉腔内隔绝术的200例DeBakeyⅢ型主动脉夹层患者的临床资料和影像学数据,对患者进行定期随访,利用单因素分析和多元Logistic回归分析对发生支架远端主动脉负性重建的危险因素进行分析。结果所有患者均顺利完成手术,吻合率88.5%。随访(1.5±0.4)年,随访期内30例(21.8%)患者支架远端主动脉出现负性重建。单因素分析发现假腔有分支灌注、夹层总长度、破口数及内漏影响主动脉重建(P<0.05);多元Logistic回归分析显示,假腔有分支灌注和破口数是患者术后支架远端主动脉负性重建的独立危险因素。结论假腔有分支灌注和破口数是影响DeBakeyⅢ型主动脉夹层腔内隔绝术后患者远端主动脉负性重建的危险因素。Objectives To evaluate the effect of hemodynamic factors on distal aortic remodeling after endovascular exclusion of DeBakey typeⅢaortic dissecting by computer tomography and imaging analysis software.Methods The clinical data and imaging data of 200 patients with DeBakey typeⅢaortic dissection who underwent endovascular exclusion in Qinghai University Affiliated Hospital from January 2014 to August 2018 were analyzed retrospectively.Patients were followed up regularly.Univariate analysis and multiple Logistic regression analysis were used to analyze the risk factors of negative remodeling of distal aortic stents.Results The operation was successfully completed in all the patients,and the anastomosis rate was 88.5%.The mean follow-up period was(1.5±0.4)years.There were negative remodelings of the distal aorta in 30(21.8%)patients during the follow-up period.Single factor analysis revealed that the branch perfusion of pseudocavity,the total length of the dissection,the number of break and the type of endoleak affected the remodeling of the aorta(P<0.05).And the multivariate Logistic regression analysis showed that the false lumen had the branch perfusion and the break number were independent risk factors for the negative remodeling of the distal aorta of the stent in patients after the operation.Conclusions The number of branch perfusion and the break in the pseudocavity are important factors affecting the negative remodeling of the distal aorta after the isolation of the aortic dissection in patients with Deakey typeⅢaortic dissection.

关 键 词：主动脉夹层 负性重建 危险因素 主动脉腔内隔绝术 

分 类 号：R543.1[医药卫生—心血管疾病]