老年人胸主动脉夹层的治疗

Clinical therapy of thoracic aortic dissection in elderly patients

目的探讨老年人胸主动脉夹层的治疗方法。方法回顾性分析46例老年胸主动脉夹层患者的临床资料。全组患者按DeBakey法分类,Ⅰ型5例,Ⅱ型16例,Ⅲ型25例。其中24例行主动脉置换术（置换组）,17例行腔内隔绝术（隔绝组）,5例采用保守治疗（保守治疗组）。结果全组患者手术死亡2例（8.3%）。随访9～21个月,术后近期死亡3例（6.8%）,余康复良好,移植物通畅,无扭曲及移位。结论对于老年胸主动脉夹层患者这一高危人群,需根据其不同情况,采用适合的治疗方法,以提高治疗效果。

Objective To explore the clinical manifestations and treatment effect in elderly thoracic aortic dissection patients. Methods The clinical data of 46 patients with aortic dissection were collected. They were diagnosed according to DeBakey typing, including type Ⅰ（5 cases, 10. 9% ）, type Ⅱ （16 cases, 52.2%）, type Ⅲ （25 cases, 37. 0%）. The patients were treated with prosthetic vessel replacement （replacement group, 24 cases）, endovascular graft exclusion （exclusion group, 17 cases） and internal medicine （internal medicine group, 5 cases）. Results Two patients died during operation. Three died soon after operation, the other 41 patients recovered unevently within the follow up time of 9 to 21 months. Conclusions Different clinical manifestations and treatment should be selected according to the different condition of aortic dissection aneurysm.