摘要
目的探讨胸主动脉腔内修复术(TEVAR)置入短支架与过长支架的临床疗效及安全性。方法选取北部战区总医院自2002年6月至2020年6月收治的379例急性主动脉综合征行TEVAR的患者为研究对象。根据覆膜支架置入长度将其分为A组(长度≥200 mm,n=182)与B组(长度<150 mm,n=197)。记录并比较两组的临床资料,以及在院期间、术后30 d与远期临床不良事件发生情况。结果B组患者男性、吸烟史、饮酒史、糖尿病史、破口距离左锁骨下动脉开口<20 mm、病变撕裂过膈肌、在院服用降糖药、他汀类药比例及入院舒张压、血红蛋白、C反应蛋白、主动脉参考血管平均直径、置入覆膜支架平均数、覆膜支架平均长度均低于A组,差异均有统计学意义(P<0.05)。在院期间,两组患者的全因死亡、新发卒中、截瘫等临床不良事件发生率比较,差异均无统计学意义(P>0.05)。术后30 d,两组患者全因死亡、新发卒中、主动脉相关不良事件、总体临床不良事件发生率比较,差异均无统计学意义(P>0.05)。远期随访中,B组患者全因死亡、新发卒中、主动脉相关不良事件、总体临床不良事件发生率及再次行TEVAR比例均高于A组,差异均有统计学意义(P<0.05)。结论TEVAR置入过长覆膜支架近远期疗效均优于置入短支架,并未增加术后截瘫的发生,安全可行。
Objective To investigate the clinical efficacy and safety of short and long stents implanted in thoracic endovascular aortic repair(TEVAR).Methods A total of 379 patients with acute aortic syndrome treated with TEVAR in General Hospital of Northern Theater Command from June 2002 to June 2020 were selected as the study subjects.The patients were divided into group A(length≥200 mm,n=182)and group B(length<150 mm,n=197)according to the length of implantation.The clinical data of the two groups were recorded and compared,as well as the incidence of long-term clinical adverse events during hospital stay,30 days after surgery.Results Group B patients were male,smoking history,drinking history,history of diabetes,crevasse distance left subclavian artery opening<20 mm,lesions tear diaphragm,in proportion to the court to take medications,statins and hospital diastolic blood pressure,hemoglobin reference,C-reactive protein and aortic vascular average diameter,average coated stents,coated stents average length were lower than group A,the differences were statistically significant(P<0.05).During hospitalization,there was no statistical significance in the incidence of all-cause death,new stroke,paraplegia and other clinical adverse events between two groups(P>0.05).Thirty days after surgery,there were no significant differences in the incidence of all-cause death,new stroke,aortic related adverse events or overall clinical adverse events between two groups(P>0.05).In the long-term follow-up,all-cause death,new stroke,aortic related adverse events,overall incidence of clinical adverse events and the proportion of recurrent TEVAR in group B were higher than those in group A,with statistical significance(P<0.05).Conclusion The short-term and long-term efficacy of TEVAR implantation of long coated stent was better than that of short stent implantation,and it did not increase the occurrence of postoperative paraplegia,so it was safe and feasible.
作者
侯抒怀
周铁楠
李智佳
彭程飞
王效增
HOU Shu-huai;ZHOU Tie-nan;LI Zhi-jia;PENG Cheng-fei;WANG Xiao-zeng(Postgraduate Training Base,General Hospital of Northern Theater Command,Jinzhou Medical University,Shenyang 110016,China;Department of Cardiology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2022年第6期562-566,共5页
Clinical Journal of Medical Officers
基金
辽宁省“兴辽英才计划”资助项目(XLYC2008004)
关键词
急性主动脉综合征
胸主动脉腔内修复术
支架置入长度
疗效
安全性
Acute aortic syndrome
Thoracic endovascular aortic repair
Length of stent implantation
Curative effect
Security
作者简介
第一作者:侯抒怀(1995-),男,吉林梅河口人,硕士;通信作者:彭程飞,E-mail:pengchengfei2000@126.com;通信作者:王效增,E-mail:wxiaozeng@163.com
