手术时机对非复杂型B型主动脉夹层患者胸主动脉腔内隔绝术后主动脉重构的影响  

Effect of Surgical Timing on Aortic Remodeling After Thoracic Aortic Endoluminal Isolation in Patients with Uncomplicated Type B Aortic Coarctation

作　　者：李键芬 Li Jianfen(Department of Cardiovascular Surgery,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]中山大学孙逸仙纪念医院心血管外科,广东广州510000

出　　处：《中外医药研究》2024年第26期30-32,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨手术时机对非复杂型B型主动脉夹层患者胸主动脉腔内隔绝术(TEVAR)后主动脉重构的影响。方法:回顾性分析2019年5月—2023年5月中山大学孙逸仙纪念医院心血管外科收治的非复杂型B型主动脉夹层腔内隔绝术患者200例的病历资料。所有患者均接受TEVAR治疗,根据发病至手术时间分组,发病1~14 d进行手术的急性期患者为对照组(n=112),发病15~30 d进行手术的亚急性期患者为观察组(n=88)。对比两组术后主动脉各平面真假腔变化。结果:术后,两组A平面真腔直径(TD)、真腔面积(TS)升高,假腔直径(FD)、假腔面积(FS)降低,观察组优于对照组(P<0.05);两组B平面TD、TS升高,FD、FS降低(P<0.05);两组C平面TS升高,FD、FS降低(P<0.05);两组B、C平面TD、FD、TS、FS比较,差异无统计学意义(P>0.05)。结论:于亚急性期对非复杂型B型主动脉夹层患者进行TEVAR术的治疗效果更好,患者主动脉近端重构良好,可有效预防夹层破裂,纠正远端缺血。Objective:To investigate the effect of surgical timing on aortic remodeling after thoracic aortic endoluminal isolation(TEVAR)in patients with uncomplicated type B aortic coarctation.Methods:Medical records of two hundred patients admitted to the Department of Cardiovascular Surgery of Sun Yat-sen Memorial Hospital,Sun Yat-sen University from May 2019 to May 2023 for uncomplicated type B aortic coarctation with endoluminal septostomy were retrospectively analyzed.All patients were treated with TEVAR and grouped according to the time from onset to surgery;patients in the acute stage who underwent surgery from 1 to 14 d of onset were the control group(n=112),and patients in the subacute stage who underwent surgery from 15 to 30 d of onset were the observation group(n=88).The postoperative changes of true and false lumen in each plane of the aorta were compared between the two groups.Results:After surgery,the true lumen diameter(TD)and true lumen area(TS)were elevated and the false lumen diameter(FD)and false lumen area(FS)were decreased in plane A of the two groups,which was better in the observation group than in the control group(P<0.05);TD and TS were elevated and FD and FS were decreased in plane B of the two groups(P<0.05);TS was elevated and FD and FS were decreased in plane C of the two groups(P<0.05);comparison of B and C plane TD,FD,TS and FS between the two groups,the difference was not statistically significant(P>0.05).Conclusion:TEVAR in patients with uncomplicated type B aortic coarctation in the subacute stage has a better therapeutic effect,and the patients have good proximal reconstruction of the aorta,which can effectively prevent rupture of the coarctation and correct distal ischemia.

关 键 词：非复杂型B型主动脉夹层 胸主动脉腔内隔绝术 主动脉重构 手术时机 

分 类 号：R654.3[医药卫生—外科学]