摘要
目的探讨腔内修复术治疗合并严重并发症的Stanford B型主动脉夹层的安全性和有效性。方法 2003年1月-2009年12月,收治60例合并严重并发症的Stanford B型主动脉夹层患者。男39例,女21例;年龄34～71岁,平均43.7岁。合并大量血胸27例,截瘫1例,急性肾衰竭7例,腹腔干严重缺血10例,肠系膜上动脉严重缺血10例,下肢严重缺血5例。患者均行带膜支架腔内修复术及相关辅助治疗,术中成功植入64个带膜支架。结果术后患者均存活并获随访,随访时间3～86个月。术前合并大量血胸者胸腔积血在术后28d～3个月完全消失;合并肾衰竭患者肾功能在术后1～9d恢复正常;合并内脏动脉和下肢严重缺血患者术后1～14d逐渐恢复血供;截瘫患者自术后4h下肢肌力开始恢复。术后主动脉CT血管造影显示真腔已恢复,假腔内血栓形成。结论腔内修复术治疗合并严重并发症的StanfordB型主动脉夹层安全、有效。
Objective To investigate the security and efficiency of endovascular repair for Stanford type B aortic dissection （AD） with severe complications. Methods Between January 2003 and December 2009, 60 patients having Stanford type B AD with severe complications were treated, including 39 males and 21 females with an average age of 43.7 years （range, 34-71 years）. Severe complications included 27 cases of huge hemothorax, 1 case of paraplegia, 7 cases of acute renal failure, 10 cases of celiac trunk ischemia, 10 cases of superior mesenteric artery ischemia, and 5 cases of severe limb ischemia. Emergency stent-graft deployment were applied in all patients, and 64 stent-grafts were successfully implanted. Results All patients survived and were followed up 3-86 months. Hemothorax disappeared after 28 days to 3 months of operation in all hemothorax patients; renal function returned normal after 1 to 9 days; limb and visceral ischemia disappeared gradually after 1 to 14 days; and muscular strength of lower limb in the paraplegia patient began to recover after 4 hours of operation. The postoperative CT angiography showed enlarged true lumen and thrombosis in the false lumen. Conclusion Emergency endovascular repair is a safe and effective method to treat Stanford type B AD with severe complications.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第9期1044-1046,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
主动脉夹层
并发症
支架
腔内治疗
Aortic dissection Complications Stent Endovascular treatment
