无溃疡样变Stanford B型主动脉壁间血肿的治疗

Treatment of Stanford B aortic intramural hematoma without ulcer-like projection

目的探讨主动脉壁无溃疡样变的Stanford B型主动脉壁间血肿(intramural hematoma,IMH)的保守治疗效果。方法回顾性分析2013年9月至2015年9月郑州大学第一附属医院收治的28例无溃疡样变的Stanford B型IMH患者的临床资料。所有患者均采用药物保守治疗,在出院前、出院后3、6个月和1年复查主动脉计算机体层摄影血管造影(computed tomography angiography,CTA),观察有无症状复发和血肿的厚度、范围变化情况。结果 28例患者均无症状出院。随访期间,3个月时,17例IMH完全吸收;6个月和1年时,28例IMH完全吸收,无症状复发者。结论对主动脉壁无溃疡样变的Stanford B型IMH患者进行严格的药物治疗能够取得满意的效果。

Objective To explore the effect of conservative treatment for Stanford B aortic intramural hematoma(IMH) without ulcer-like projection. Methods During the period from September 2013 to September 2015, 28 patients with Stanford B aortic IMH without ulcer-like projection were treated in the First Affiliated Hospital of Zhengzhou University, the clinical data were retrospectively analyzed. All the patients received conservative treatment. Computed tomography angiography(CTA) of the aorta was performed before discharge, as well as 3, 6, 12 months postdischarge, in order to observe the symptom recurrence and the changes of the thickness and range of the hematoma. Results All the patients were asymptomatic post-discharge. During the follow-up period, the intramural hematoma was absorbed completely in 17 patients after 3 months; after 6 and 12 months, the intramural hematoma was absorbed in 28 patients and there was no recrudescence patient. Conclusion For Stanford B aortic IMH without ulcer-like projection, conservative treatment can achieve satisfactory results.