胸主动脉腔内修复术治疗急性B型主动脉夹层临床分析.docVIP

胸主动脉腔内修复术治疗急性B型主动脉夹层临床分析 　　[摘要] 目的 分析胸主动脉腔内修复术治疗急性B型主动脉夹层临床效果。 方法 随机选择2014年2月―2015年1月来该院治疗急性B型主动脉夹层的患者70例，随机将其分成两组，每组35例。A组为复杂性急性B型主动脉夹层，B组为非复杂性急性B型主动脉夹层。观察两组患者临床转归和动脉重塑情况。 结果 两组患者在水平动脉扩张发生率、各动脉段动脉重塑发生率、Ia内漏、支架远端再发夹层和逆行性A型夹层发生率方面差异无统计学意义（P0.05）。结论 采用胸主动脉腔内修复术治疗复杂性和非复杂性急性B型主动脉夹层在生存率和并发症发面无明显差异，但是在动脉重塑方面，非复杂性急性B型主动脉夹层效果更明显，具有较高的安全性和可行性。 　　[关键词] 胸主动脉腔内修复术；急性B型主动脉夹层；临床效果 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）11（c）-0008-02 　　[Abstract] Objective To analyze the clinical effect of thoracic endovascular aortic repair in the treatment of acute type B aortic dissection. Methods 70 cases with acute type B aortic dissection treated in our hospital from February 2014 to January 2015 were selected and randomly divided into two groups， group A（complicated acute type B aortic dissection） and group B（non-complicated acute type B aortic dissection） with 35 cases in each. And the clinical outcome and arterial remodeling of the two groups were observed. Results There were no statistically significant differences in the incidence of horizontal arterial distension， arterial remodeling rate in each arterial segment， Ia endoleak rate， stent distal recurrence rate of type A dissection and incidence of retrograde type A dissection between the two groups（P0.05）. Conclusion There were no differences in the survival rate and incidence of complications between complicated acute type B aortic dissection and non-complicated acute type B aortic dissection treated by thoracic endovascular aortic repair. However， the treatment was more significant and safer and more feasible on the non-complicated acute type B aortic dissection in the aspect of arterial remodeling. 　　[Key words] Thoracic endovascular aortic repair； Acute type B aortic dissection； Clinical effect 　　主动脉夹层是主动脉疾病中较常见的一种，其发病率高，死亡率高[1]。目前临床一般采用手术治疗主动脉夹层，取得了一定效果。但是传统观点认为，对非复杂性急性B型主动脉夹层应该采用保守方法治疗，给予患者使用药物，而对于复杂性急性B型主动脉夹层才应该采取手术治疗[2]。通过大量临床报告发现，使用手术治疗的死亡率不断上升，已经严重威胁患者的正常生活[3]。为了减少死亡率，该研究对2014年2月―2015年1月来该院治疗急性B型主动脉夹层的患者分成复杂性和非复杂