Stanford B型主动脉夹层腔内修复术后早期主动脉重塑的影响因素  

Influencing factors of early aortic remodeling after endovascular repair of Stanford type B aortic dissection

作　　者：海依娜尔·赛力克汗 刘军乐[1] 丁贺义 陈轩 于泽坤 赛力克·马高维亚[2] 胡西塔尔 达尔汗 Haiyinaer Sailikehan;Liu Junle;Ding Heyi;Chen Xuan;Yu Zekun;Sailike Magaoweiya;Huxitar;Darhan(Department of Vascular Surgery,Karamay Central Hospital of Xinjiang,Karamay 834099,China;Department of Vascular and Thyroid Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆克拉玛依市中心医院血管外科,新疆克拉玛依834099 [2]新疆医科大学第一附属医院血管甲状腺外科,新疆乌鲁木齐830054

出　　处：《中国血管外科杂志（电子版）》2024年第2期133-138,共6页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：克拉玛依市科技计划项目(20212022hjcxrc0017)。

摘　　要：目的探讨Stanford B型主动脉夹层患者行胸主动脉腔内修复术后早期主动脉重塑的影响因素。方法收集2020年1月至2023年6月新疆医科大学第一附属医院和克拉玛依市中心医院首次接受标准胸主动脉腔内修复术的81例患者临床资料,根据患者术后假腔是否完全血栓形成分组并使用多因素Logistic回归分析主动脉重塑的影响因素。结果患者手术均取得成功。30例患者假腔完全血栓形成,51例假腔不完全血栓形成。血小板计数(比值比1.01,95%置信区间=1.00~1.01)和支架远端与首次折返撕裂的距离(比值比1.22,95%置信区间=1.05~1.41)是B型主动脉夹层腔内修复术后早期主动脉重塑的独立危险因素,回归模型的受试者工作特征曲线的曲线下面积为0.780。结论血小板计数与支架远端与首次折返撕裂距离是B型主动脉夹层腔内修复术后早期主动脉重塑的独立危险因素。Objective To investigate the influencing factors of early aortic remodeling after endovascular repair in patients with Stanford type B aortic dissection.Methods The clinical data of 81 patients who underwent standard endovascular aortic repair for the first time in the First Affiliated Hospital of Xinjiang Medical University and Karamay Central Hospital from January 2020 to June 2023 were collected.The patients were divided into two groups according to whether the false lumen was completely thrombosed after surgery,and multivariate logistic regression was used to analyze the influencing factors of aortic remodeling.Results The surgery was successful in all patients.Complete thrombosis of the false lumen occurred in 30 patients,and incomplete thrombosis of the false lumen occurred in 51 patients.Platelet count(odds ratio=1.01,95%confidence interval=1.00-1.01)and the distance between the distal end of the stent and the first reentry tear(odds ratio=1.22,95%confidence interval=1.05-1.41)were independent risk factors for early aortic remodeling after endovascular repair of type B aortic dissection.The area under the curve of the receiver operating characteristic curve of the regression model was 0.780.Conclusion Platelet count and the distance between the distal end of the stent and the first reentry tear are independent risk factors for early aortic remodeling after endovascular repair of type B aortic dissection.

关 键 词：主动脉夹层 主动脉形态 主动脉重塑 影响因素 LOGISTIC回归 

分 类 号：R654.3[医药卫生—外科学]