不同时机胸主动脉腔内修复术治疗Stanford B型主动脉夹层的效果对比  

Comparison of the Effect of Different Timing of Thoracic Aortic Endovascular Repair Surgery in the Treatment of Stanford B-Type Aortic Dissection

作　　者：范逸松 王瑞 FAN Yisong;WANG Rui(Cardio-Thoracic Surgery,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院心胸外科,河南信阳464000

出　　处：《河南医学研究》2025年第8期1454-1457,共4页Henan Medical Research

摘　　要：目的 分析不同时机胸主动脉腔内修复术治疗Stanford B型主动脉夹层的效果。方法 收集信阳市中心医院2020年1月至2023年10月收治的103例Stanford B型主动脉夹层患者病历资料,患者均接受胸主动脉腔内修复术治疗,依据治疗时机分为两组,急性组(52例)于发病<14 d行手术治疗,非急性组(51例)于发病≥14 d行手术治疗。对比两组围手术期相关情况[平均发病至治疗时间、住院时间、28 d病死率、住院花费]、术前及术后3个月胸主动脉重塑(AR)情况[真腔/主动脉直径比(TLi)、最大真假腔直径比值、假腔/主动脉直径比(FLi)]、假腔血栓形成情况、并发症发生情况。结果 与非急性组比较,急性组平均发病至治疗时间、住院时间较短,28 d病死率较低,住院花费较少(P<0.05)。术后3个月,急性组TLi高于非急性组,FLi低于非急性组,且均较术前改善(P<0.05)。两组术前、术后3个月最大真假腔直径比值差异无统计学意义(P>0.05),但术后3个月较术前改善,差异有统计学意义(P<0.05)。急性组假腔血栓完全吸收率较非急性组高(P<0.05);术后1个月,两组卒中、覆膜支架远端新发夹层、内漏、脊髓缺血、逆撕A型夹层、急性肾损伤发生率差异无统计学意义(P>0.05)。结论 早期行胸主动脉腔内修复术治疗Stanford B型主动脉夹层,能缩短患者治疗及住院时间,减轻住院经济负担,提升效果,改善预后。Objective To analyze the effect of different time thoracic aortic endovascular repair surgery in the treatment of Stanford B-type aortic dissection.Methods The medical records of 103 patients with Stanford B-type aortic dissection in Xinyang Central Hospital from January 2020 to October 2023 were collected,all patients underwent thoracic aortic endovascular repair surgery,they were divided into two groups according to the timing of treatment,the acute group(52 cases)received surgery less than 14 days after onset,and the non-acute group(51 cases)received surgery more than 14 days after onset.The perioperative related conditions[average time from onset to treatment,length of hospital stay,28 d mortality,hospitalization cost]in the two groups were compared,and thoracic aortic remodeling[true lumen/aortic diameter ratio(TLi),maximum true false lumen diameter ratio,false lumen/aortic diameter ratio(FLi)],false lumen thrombosis,and complications were also compared before and 3 months after surgery.Results Compared with the non-acute group,the acute group had shorter average time from onset to treatment,shorter hospital stay,lower 28 day mortality,and less hospitalization costs(P<0.05).Three months after surgery,the TLi in the acute group was higher than that in the non-acute group,and the FLi was lower than that in the non acute group,both of which improved compared to preoperative levels(P<0.05).There was no statistically significant difference in the maximum true false lumen diameter ratio between the two groups before and 3 months after surgery(P>0.05),but there was a statistically significant improvement compared to before surgery at 3 months after surgery(P<0.05).The complete absorption rate of false lumen thrombosis in the acute group was higher than that in the non-acute group(P<0.05).One month after surgery,there was no statistically significant difference in the incidence of stroke,new dissection of the distal end of the covered stent,internal leakage,spinal cord ischemia,reverse tearing type A dissection,and

关 键 词：主动脉夹层 Stanford B型 胸主动脉腔内修复术 胸主动脉重塑 假腔血栓形成 

分 类 号：R543.1[医药卫生—心血管疾病]