55例debakeyⅲ型主动脉夹层腔内隔绝术的随访分析 word格式.docxVIP

55 例 Debakey Ⅲ型主动脉夹层腔内隔绝术的随访研究摘要【目的】 通过对55例在我院行主动脉腔内隔绝术（EVGE）修复Debakey III型 主动脉夹层患者的随访，总结Debakey III型主动脉夹层腔内修复治疗的经验， 探索该技术的临床应用前景。【方法】 2006年4月-2012年8月，行主动脉腔内隔绝术（EVGE）修复的Debakey Ⅲ型主动脉夹层患者共55例，术前均接受CT血管造影（CTA）检查，以获取患者 主动脉夹层相关的解剖学资料，术中在数字减影血管造影（DSA）直视下对所有 患者行腔内修复。按照术后0.5，3，6，12个月及以后每年1次的方案进行随访， 观察并发症发生及瘤体形态学变化。【结果】 全组患者技术成功率为89.1%（49/55），临床成功率为87.3%（48/55）。 CTA显示术后3个月所有患者假腔均形成血栓，无支架移位及变形，并且真腔内径 扩大，假腔内径缩小（1例除外），随访期间降主动脉整体直径未见明显变化。 术后出现I型内漏5例（9.1%），其中1例术后出院前复查CTA显示内漏已消失，1 例半年后消失，3例持续内漏。封堵左锁骨下动脉的7例患者中，2例患者（均为 完全封堵左锁骨下动脉）出现左上肢麻木无力，血压较右侧约低50～60 mmHg， 无头晕、头痛等症状，CTA显示左锁骨下动脉远端显影良好。1例出院后15 d不明 原因猝死，1例术后23个月出现脑梗死。所有患者均无胸痛、胸闷等症状，无截 瘫发生。【结论】 主动脉夹层腔内隔绝术具有创伤小、成功率高、操作简便、围手术期 并发症率及死亡率低，是一种安全有效的治疗方法，早中期效果满意，但远期疗 效需待进一步随访。【关键词】：主动脉夹层，腔内隔绝术，随访研究Follow-up of Debakey Ⅲ Type Aortic Dissection Treated by Endovascular GraftExclusion(Report of 55 Cases) AbstractObjectiveThe purpose of this research is to introduce the endovascular repair experience of treating 55 cases of Debakey Ⅲ type aortic dissection by endovascular implantment of stent-grafts, to explore the clinical application prospect ofendovascular repairment..MethodsWe retrospectively studied 55 patient s who had been treated From 2006 April to 2012 August, Imaging examination by computed tomographyangiography（CTA）were done to obtain anatomical detail of dissection. Stent-graftswere implanted under the guide of DSA in all cases. The patients were followed-up for 3 months，6 months，12 months，and then annually by CTA examination to observe the complications and morphological changes of the aneurysm.ResultsThe technical success rate was 89.1% (49/55),the clinical success rate was 87.3% (48/55). Thromblization of false lumen was clear，no stent displacement and deformation has been found ,the inside diameter of the true lumen was expanded,the inside diameter of the false lumen was narrowed (except one case), there was no significant change in the overall diameter of the descending aorta during follow-up . type I endoleak was diagnosed in