胸主动脉减速伤18例患者的腔内治疗

Endovascular treatment of 18 cases of transection traumatic thoracic aorta injuries

目的探讨主动脉腔内修复术对胸主动脉减速伤的治疗情况及效果。方法分析2009—06～2012—06间18例主动脉腔内修复术治疗胸主动脉减速伤患者的临床资料。患者均为高速交通事故所致，对患者的一般信息、病变情况及住院手术情况进行分析，并于术后固定时间（术后1周，6个月及1年）进行随访。结果操作技术成功率100％，平均手术时间110min（60—180min）。I型内漏1例，术后6个月内漏自愈。肱动脉穿刺点假性动脉瘤1例（出院后2周发现），行肱动脉假性动脉瘤切除术。18例患者均无死亡。结论接受主动脉腔内修复术患者的短期及中期预后比较稳定。主动脉腔内修复术将可能成为治疗胸主动脉减速伤的首选治疗方法。

Objective To explore the treatment and efficacy of endovascular repair for acute traumatic thoracic aorta rupture. Methods The clinical data of 18 patients with acute traumatic thoracic aorta lesion undergoing thoracic endograft from June 2009 to June 2012 were retrospectively analyzed,including age, sex, type and site of the lesion, type of endovascular graft, endovascular opera- tion time, length of stay in the critical care medicine, length of stay in the hospital, immediate and perioperative complications, and mor- tality. Follow-up data were recorded at 1 week,6 and 12 month after surgery. Results All endovascular procedures were technically successful,and the mean operating time for the endovascular procedure was 110 rain （60 -180 min）. One ease of endoleak was found and self-healed after 6 months. Another case of a brachial artery pseudoaneurysm was found and cured by an brachial artery pseudoan- eurysm ectomy. The perioperative and postoperative mortality rate was O. Conclusion The short- and mid-term results of endovascular repair of traumatic aortic injuries are promising and the endovascular repair could be the preferred method in treatment of transection traumatic thoracic aorta injuries.