不同期Stanford B型胸主动脉夹层腔内修复术后疗效及主动脉重塑的临床研究

No clinical study on the postoperative efficacy and aortic remodeling in the thoracic aortic dissection of the Stanford B thoracic aorta

目的研究不同期的Stanford B型胸主动脉夹层行腔内修复术(TEVAR)后的疗效比较及胸主动脉的重塑情况。方法研究采用回顾性分析的方法,选择2010年1月至2017年6月来本院就诊的Stanford B型胸主动脉夹层并行TEVAR的患者共110例,其中亚急性期实施TEVAR的患者32例,慢性期实施TEVAR的患者78例,手术均顺利进行,对2组患者术后内漏、逆行性主动脉夹层和截瘫等并发症发生率、假腔血栓形成、胸主动脉重塑等情况进行统计分析。结果 2组患者术后并发症发生率比较差异无统计学意义,但亚急性期患者假腔血栓形成情况优于慢性期患者,血栓完全吸收率高,且亚急性期患者胸主动脉重塑情况优于慢性期患者,差异有统计学意义(P<0.05)。结论 Stanford B型胸主动脉夹层在亚急性期实施TEVAR具有更好地临床效果,更有利于主动脉的重塑,具有重要的临床参考价值。

Objective To study the curative effect of the treatment of the thoracic aortic dissection（TEVAR） of the Stanford B thoracic aorta（TEVAR） and the reconstruction of the thoracic aorta. Methods Adopt the method of retrospective analysis, a total of 110 patients with Stanford type B thoracic aortic dissection and TEVAR who visited our hospital from January 2010 to June 2017 were selected, 32 patients with subacute phase of the implementation of TEVAR among them, 78 patients with chronic phase implementation of TEVAR, are performed smoothly, and within the two groups of patients with postoperative leakage, retrograde aortic dissection and paraplegia complication rates and false lumen thrombosis, thoracic aorta remodeling, and so on and so forth for statistical analysis. Results The incidence of postoperative complications was similar in both groups, there was no statistically significant difference, but the false lumen thrombosis in patients with subacute phase is better than that of patients with chronic, thrombus completely absorption rate is high, and thoracic aorta remodeling in patients with subacute phase is better than that of patients with chronic, the difference was statistically significant（P〈0.05）. Conclusion The treatment of the Stanford B thoracic aortic dissection in subacute phase of TEVAR has a better clinical effect, which is more conducive to the reconstruction of the aorta, and has important clinical reference value.