DeBakeyⅢ型夹层动脉瘤30例诊治分析

Management of 30 patients with DeBakey type Ⅲ dissecting aortic aneurysm

目的 :总结 3 0例DeBakeyⅢ型主动脉夹层动脉瘤 (dissectingaorticaneurysm ,DAA)的诊断和治疗体会。方法 :对 3 0例DeBakeyⅢ型DAA病人进行回顾性分析 ,其中急性 2 5例 ,慢性 5例。手术治疗 8例 ,非手术治疗 2 2例。结果 :急性期死亡 4例 ,1例术后 3年死亡。 6个月～ 6年的随访观察 ,1年生存率和 3年生存率 ,手术组分别是 87.7% ( 6 7)和 66.7% ( 2 3 ) ,非手术组为 87.5 % ( 14 16)和 72 .7% ( 8 11) ,两组比较差异无显著性 (P >0 .0 5 )。结论 :DeBakeyⅢ型DAA应采取综合治疗 ,早期诊断及积极、长期的非手术治疗可明显改善预后。腔内修复术提供了治疗新途径 。

Objective:To summarize the experience of diagnosis and treatment in 30 patients with DeBakey type Ⅲ dissecting aortic aneurysm(DAA).Methods:All clinical data was retrospectively analyzed.Eight patients were operated and medicine and other non-surgery methods treated the else.Results:Four patients died in acute period.The follow-up was from 0.6 to 6 years.Three non-surgery patients died of various causes on 10 months,2 years and 4.5 years after illness.One patient died suddenly on the third postoperative day and another died of rupture of aneurysm on the third years.Survival rate in non-surgery group was 87.5%(14/16) on 1 year and 72.7%(8.11) on 3 years,but the survival rate in operation group was 85.7%(6/7) on 1 year and 66.7%(2/3) on 3 years.There was not any significant difference between the two teams(P>0.05).Conclusion:Early diagnosis and non-surgery treatment may improve the prognosis of DeBakey type Ⅲ DAA.The Endovascular Repair(EVR) is a new method.The surgical indication of these patients should be well grasped and close follow-up is necessary.