B型主动脉夹层腔内治疗的疗效分析

The analysis of intravascular treatment effect in Type B aortic dissection

目的探讨覆膜支架治疗B型主动脉夹层的有效性和安全性。方法病例选择B型主动脉夹层患者22例,男16例,女6例,年龄33～68岁,平均(47.0±10.2)岁。所有患者术前均经螺旋CT检查或MRI检查明确诊断为Standford B型主动脉夹层。入院后7～14天行主动脉内造影,进一步明确诊断后覆膜支架治疗,观察术中、术后及出院后1年内并发症情况,分析其临床特点、疗效及随访结果。结果 22例成功均一次成功置入腔内覆膜支架,手术成功率100%。手术时间为90～150min,术后住院期间,11例不同程度的发热,血白细胞数增高,短期内给予激素及抗生素等治疗好转。随访12个月,无死亡病例,临床疗效显著。CTA复查,21例假腔内完全血栓形成,1例远端内漏患者假腔内部分血栓形成,降主动脉直径并无增大。结论覆膜支架治疗B型主动脉夹层成功率高、创伤小、并发症少,具有显著的临床疗效。

Objective To test the efficiency and safety of coated stents in treatment of type B aortic dissection. Methods Twenty-two cases with type B aortic dissection were selected in random, with male 16 cases, female 6 cases, aged 33 to 68 years, average （47.0 ＋/-10.2 years old. All of the patients were diagnosed preoperatively by spiral CT examination or MRI clearly as a Standford type B aortic dissection. Seven to 14 days after admission, aortic angiography was done to further diagnose and coated stents was placed for treatment. Complications were observed in intraoperative and postoperative one year. Its clinical characteristics, treatment effect and follow-up results were analyzed. Results All the patients were successfully implanted coated stents in onetime, the success rate was 100%. The operation time ranged from 90 min to 150 min. During postoperative hospitalization, 11 cases had different degree of fever, white blood count increased, the situation was improved after given antibiotics and steroid in short term. Follow-up of 12 months, no death occurred, clinical curative effect was distinct. In CTA review, vascular false lumen completely thrombosis in 21 cases, distal leakage patients false lumen partial thrombosis in 1 case, the descending aorta diameter had no increased. Conclusion Coated stents in treatment of type B aortic dissection has high success rate, little trauma and less complications, has the remarkable clinical curative effect.