B型主动脉壁间血肿治疗策略的选择

Treatment strategy for Stanford B aortic intramural hematoma

目的:探讨Standford B型主动脉壁间血肿的治疗策略的选择。方法:总结我院2年期间通过内科药物和腔内修复手术治疗的Standford B型主动脉壁间血肿患者16例,根据患者治疗结果进行评价主动脉壁间血肿治疗策略的选择。结果:16例患者中,药物治疗的患者6例,腔内修复治疗的患者10例(其中4例是由于药物治疗后症状持续加重转为腔内修复手术治疗的)。腔内治疗患者均存活,药物治疗组中死亡2例,均为出现急性主动脉夹层引起死亡。结论:腔内修复治疗对于Standford B主动脉壁间血肿是安全可行治疗选择。

AIM： To explore the treatment choices for Stanford B type intramural hematoma. METHODS： We performed a retrospective study of 16 patients with Stanford B intramural hematoma who had been treated with medical therapy or endovaseular stent graft. Therapeutic strategy was evaluated by therapy results. RESULTS： Among the 16 patients, six received medical therapy and 10 patients received endo- vascular stent graft. Four patients in the medical therapy group received stent graft for sustained pain or progressive dissection of the descending aorta. Ten patients receiving stent graft. All patients recovered with the exception of two patients in the medically treated group who died of abrupt aortic dissection. CONCLUSION： Endovaseular stent graft placement is safe and feasible as well as being superior and more effective than medical therapy for patients with Stanford B intramural hematoma.