血管腔内治疗主动脉夹层和夹层动脉瘤的技术方法及疗效分析  

The technical method and curative effect analysis of endovascular treatment for aortic dissection and dissecting aneurysm

作　　者：邓建武[1] 王子路 张海军[1] Deng Jianwu;Wang Zilu;Zhang Haijun(Department of Vascular Surgery,the Second People's Hospital of Lianyungang,Lian yungang,Jiangsu222006,China)

机构地区：[1]连云港市第二人民医院血管外科,江苏连云港222006

出　　处：《医药前沿》2020年第36期16-17,共2页Journal of Frontiers of Medicine

摘　　要：目的:探讨血管腔内治疗主动脉夹层和夹层动脉瘤的技术方法及疗效。方法:选择2017年1月—2020年6月在我院血管外科治疗的24例主动脉夹层和夹层动脉瘤患者,均采用覆膜支架主动脉腔内修复术(TEVAR),分析疗效(手术成功率、死亡率、并发症发生率、各项手术及住院指标)。结果:24例患者中,男19例,女5例,年龄31~65岁,平均年龄(46.2±0.5)岁,均为Stanford B型主动脉夹层和降主动脉瘤;24例患者中,手术成功23例(95.83%)、死亡1例(4.17%),23例患者均恢复良好,顺利出院;术后3~5d复查CTA,均支架定位准确,原发破口及胸主动脉假腔封闭严密22例,仅有1例发生微量内漏,无需特殊处理;手术时间(98.39±10.12)min、选择性脑灌注时间(27.15±8.46)min、术后24h引流量(609.13±68.94)ml、住院时间(10.15±2.68)d。结论:TEVAR治疗主动脉夹层和夹层动脉瘤的疗效显著,创伤小,手术时间短,并发症发生率低,术后恢复快,整体病死率低,为临床治疗提供了新的手术方法。Objective To investigate the technique and efficacy of endovascular treatment of aortic dissection and dissecting aneurysm.Methods Retrospective analysis of the clinical data of 24 patients with aortic dissection and dissecting aneurysm treated in vascular surgery in our hospital from January 2017 to June 2020,all were treated with laminating stent aortic repair(TEVAR),analyzed the curative effect(success rate,mortality rate,complication rate,operation and hospitalization index).Results Of the 24 patients,19 were male and 5 were female,aged 31-65,with an average age(46.2±0.5)years,all Stanford B aortic dissection and descending aortic aneurysm;Of the 24 patients,23 were successful(95.83%),1 died(4.17%),23 recovered well and discharged smoothly.After 3~5d,the stent location was accurate CTA,the primary rupture and the false seal of thoracic aorta were tight in 22 cases,only 1 case had micro leakage without special treatment;Operation time(98.39±10.12)min,selective cerebral perfusion time(27.15±8.46)min,24 postoperative induced flow(609.13±68.94)ml,hospitalization time(10.15±2.68)d.Conclusion TEVAR treatment of aortic dissection and dissecting aneurysm is effective,with small trauma,short operation time,low incidence of complications,fast postoperative recovery and low overall mortality,which provides a new surgical method for clinical treatment.

关 键 词：主动脉夹层 夹层动脉瘤 血管腔内治疗 覆膜支架 主动脉腔内修复术 疗效 

分 类 号：R654.3[医药卫生—外科学]