摘要
目的比较支架复合装置和单纯胸主动脉腔内修复术(TEVAR)治疗急性B型主动脉夹层(TBAD)伴分支血管灌注不良的近期疗效。方法选取2012年8月-2020年8月浙江省丽水市人民医院收治的急性TBAD伴分支血管灌注不良的患者120例,按照支架植入类型不同分为覆膜支架组52例与复合装置组68例。覆膜支架组采用单纯TEVAR治疗(胸主动脉覆膜支架),复合装置组采用胸主动脉覆膜支架+腹主动脉裸支架治疗,比较两组手术情况以及术后30天愈后。结果复合装置组术后30天灌注不良有关死亡率低于覆膜支架组,差异有统计学意义(P<0.05)。复合装置组术后30天腹主动脉真腔直径大于覆膜支架组,假腔直径小于覆膜支架组,差异均有统计学意义(均P<0.05)。结论与单纯使用TEVAR治疗急性TBAD伴灌注不良相比,使用支架复合装置治疗后能降低灌注不良相关死亡率,且远端腹主动脉的真腔扩张及假腔缩小更显著,有助于改善分支血管灌注不良状态。
Objective To compare the short-term efficacy of stent composite device and pure thoracic aortic endovascular repair(TEVAR)in the treatment of acute type B aortic dissection(TBAD)with poor perfusion of branch vessels.Methods From August 2012 to August 2020,120 patients with acute TBAD with poor perfusion of branch vessels were enrolled in the People’s Hospital of Lishui City,Zhejiang Province.According to the type of stent implantation,they were divided into 52 cases of stent graft group and 68 cases of composite device group.example.The stent graft group was treated with TEVAR alone(thoracic aorta stent graft),and the combined device group was treated with thoracic aorta stent graft+abdominal aorta bare stent.The surgical conditions and the prognosis 30 days after the operation were compared between the two groups.Results The mortality rate of poor perfusion in the composite device group was lower than that in the stent graft group at 30 days postoperatively,and the difference was statistically significant(P<0.05).The diameter of the true lumen of the abdominal aorta in the composite device group was larger than that of the stent graft group,and the diameter of the false lumen was smaller than that of the stent graft group.The differences were statistically significant(all P<0.05).Conclusion Compared w ith the treatment of acute TBAD with poor perfusion using TEVAR alone,the use of a stent composite device can improve the mortality related to poor perfusion,and the true lumen expansion and false lumen shrinkage of the distal abdominal aorta are more significant,which may be more helpful Improve poor perfusion of branch vessels.
作者
毛茅
叶永根
雷国伟
舒鹏飞
冯玉灵
MAO Mao;YE Yonggen;LEI Guowei;SHU Pengfei;FENG Yuling(Lishui people's Hospital,Lishui 323000,China)
出处
《浙江实用医学》
2021年第3期181-184,共4页
Zhejiang Practical Medicine
关键词
B型主动脉夹层
血管灌注不良
胸主动脉腔内修复
B-type aortic dissection
poor vascular perfusion
Thoracic aortic endovascular repair
