急性Stanford B型主动脉夹层腔内修复治疗时机与预后的关系Investigate on the correlations between the time of thoracic endovascular aortic repair and prognosis in patients with acute Stanford type B aortic dissection
杨洁连,向定成,肖华,彭丹丹,张金霞
摘要(Abstract):
目的探讨急性Stanford B型主动脉夹层(AADB)腔内修复治疗时机与预后的关系。方法回顾性分析接受经皮主动脉腔内修复术(TEVAR)的156例AADB患者的临床资料,分为发病至TEVAR时间≤7 d组(G1组)、发病至TEVAR时间为7~14 d组(G2组)和发病至TEVAR时间>14 d组(G3组),比较三组术后3个月主动脉修复情况、院内死亡、平均住院时间及住院费用。结果术前三组患者最小真腔直径与最大假腔直径的比值分别为(0.47±0.33)、(0.42±0.18)及(0.47±0.27)(P>0.05),术后3个月最大真腔直径与最大假腔直径比值分别为(1.76±0.51)、(1.42±0.30)及(1.34±0.34),组间两两比较G1组显著大于G2组和G3组(P<0.05),G2组与G3组比较差异无统计学意义(P>0.05);术后3个月12例达到主动脉完全修复(G1组8例和G2组4例);院内死亡患者8例,其中5例因脏器缺血致死,2例因近段夹层形成在术中死亡,1例为不明原因猝死;G1组和G2组的平均住院时间显著少于G3组(P<0.05),与G3组相比,G1组及G2组的住院费用减少了20000元/人。结论 AADB早期进行TEVAR术有利于术后主动脉修复,可以减少住院时间及费用且安全性可以接受。
关键词(KeyWords): 急性主动脉夹层;经皮胸主动脉腔内修复术;预后
基金项目(Foundation):
作者(Author): 杨洁连,向定成,肖华,彭丹丹,张金霞
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