不同分期高危非复杂型Stanford,B型主动脉夹层行胸主动脉腔内修复术的疗效分析  

Results of thoracic endovascular aortic repair for high-risk uncomplicated Stanford B aortic dissection by different stages

作　　者：霍静 肖玉林 沈祥怡 吴忠隐 刘晓博 张弘[2] Huo Jing;Xiao Yulin;Shen Xiangyi;Wu Zhongyin;Liu Xiaobo;Zhang Hong(General Medical Department,the Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Vascular Surgery,the Affiliated Hospital of Chengde Medical College(Hebei Key Laboratory of Pan vascular Diseases),Chengde 067000,China)

机构地区：[1]承德医学院附属医院全科医疗科,承德067000 [2]承德医学院附属医院血管外科(河北省泛血管疾病重点实验室),承德067000

出　　处：《中华普通外科杂志》2025年第1期51-56,共6页Chinese Journal of General Surgery

基　　金：河北省民生科技专项(20377792D)。

摘　　要：目的探讨急性期与亚急性期高危非复杂型Stanford B型主动脉夹层行胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)的疗效差异。方法回顾性分析2014年1月至2020年10月在承德医学院附属医院行TEVAR治疗的高危型非复杂Stanford B型主动脉夹层患者的临床及随访资料。结果126例患者按照发病至手术时间分为急性期组(n=65,1~14 d)与亚急性期组(n=61,15~90 d)。亚急性期组患者的平均住院时间低于急性期组患者(P<0.05)。术后1年急性期组患者腹主动脉段假腔血栓化情况优于亚急性期组患者(P<0.05)。亚急性期组患者院内总不良事件发生率(总并发症和死亡)低于急性期组患者(P<0.05);两组患者远期总不良事件发生率差异无统计学意义(P>0.05)。结论在亚急性期行TEVAR术治疗高危非复杂型Stanford B型主动脉夹层,术后不良事件发生率较低,患者获益更大。Objective To investigate the difference in efficacy of thoracic endovascular aortic repair(TEVAR)for high-risk uncomplicated Stanford B aortic dissection in acute versus subacute phase.Methods The clinical and follow-up data of of 126 patients with high-risk,uncomplicated Stanford B aortic dissection treated with TEVAR at the Affiliated Hospital of Chengde Medical College from Jan 2014 to Oct 2020 were retrospectively analyzed.Results One hundred and twenty-six patients were divided according to the time from onset to surgery into an acute phase group(n=65,1-14 days)and a subacute phase group(n=61,15-90 days).The average hospital stay of patients in the subacute phase group was significantly shorter than that of patients in the acute phase group(P<0.05).One year post-operatively,abdominal aortic false lumen thrombosis in patients of the acute phase group was better than that in the subacute phase group(P<0.05).The in hospital overall incidence of adverse events(total complications+death)was lower in the subacute phase group than in the acute phase group(P<0.05).The difference in the long-term overall incidence of adverse events between the two groups was not statistically significant(P>0.05).Conclusion sThe TEVAR procedure for high-risk,uncomplicated Stanford B aortic dissection performed during the subacute phase had a lower postoperative in hospital incidence of adverse events.

关 键 词：主动脉疾病 支架 非复杂型Stanford B型主动脉夹层 分期 不良事件 

分 类 号：R654.3[医药卫生—外科学]