Stanford B型主动脉夹层腔内修复术后远端负性重塑相关因素浅析  

The risk factors of distal aorta negative remodeling after endovascular aortic repair in type B dissection

作　　者：张岚林 阳晟[1] 高慧强[1] 许尚栋[1] Zhang Lanlin;Yang Sheng;Gao Huiqiang;Xu Shangdong(Cardiac Surgery Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Aortic Disease Diagnosis and Treatment Research Center,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科中心,北京市大血管疾病诊疗研究中心,北京100029

出　　处：《中华外科杂志》2022年第11期987-991,共5页Chinese Journal of Surgery

基　　金：北京市自然科学基金(L192045)。

摘　　要：近年来,Stanford B型主动脉夹层在治疗方式上有了巨大的进展,腔内修复技术已成为其主要治疗手段。但该技术仅针对原发破口区域进行修复,远端常残留破口及夹层,部分患者远期会发生主动脉远端扩张甚至破裂。目前已有多项关于主动脉重塑影响因素的研究,为判断患者预后提供了一些参考。相较于正常的主动脉,慢性夹层患者的主动脉壁顺应性下降,患者往往预后不良。主动脉承载血流的运输,影响血流动力学的各种因素亦会影响主动脉的重塑。有研究者报告了数项负性重塑的相关因素,并在腔内修复术的基础上增加了辅助技术,取得了可喜的成果。然而,面对每例患者的不同情况,具体治疗方式尚不明确,影响主动脉重塑效果的因素仍未研究清晰。进一步明确负性重塑的影响因素,有助于筛选高危患者,优化治疗方案,改善患者预后。In recent years,great progress has been made in the treatment of Stanford type B aortic dissection,especially endovascular repair technology has become the main treatment.However,it is only used to repair the primary tear,the residual tears and false lumen are often left at the distal end,which causes adverse events such as distal aortic dilatation or even rupture.At present,there are many studies on the influencing factors of aortic remodeling,which provide some references for the prognosis of patients.The aorta carries the transportation of blood flow,and various factors affecting hemodynamics also affect the remodeling of aorta.Some researchers reported several factors related to negative remodeling and added auxiliary techniques,and achieved gratifying results.However,because of the different conditions of each patient,the specific treatment method is still unclear,the factors affecting the aortic remodeling effect also have not been thoroughly studied.Clarifying the influencing factors of negative remodeling is helpful to screen high-risk patients,optimize the treatment plan and improve the prognosis.

关 键 词：动脉瘤 夹层 主动脉 重塑 远端破口 

分 类 号：R654.3[医药卫生—外科学]