Stanford B型主动脉夹层远端破口的初步临床探讨

目的 探索性提出Stanford B型主动脉夹层远端破口的腔内修复原则.方法 新疆维吾尔自治区人民医院血管外科2013年1月-2015年1月收治的101例Stanford B型主动脉夹层患者,按照不同的处理原则将患者分为两组:(1)序贯处理组57例:采取由近至远的原则腔内修复主动脉破口(如不处理内脏动脉处破口,亦不处理其远端破口);(2)非序贯处理组44例:不按照由近至远的原则腔内修复主动脉破口(不处理累及内脏动脉破口,其余远端破口行腔内修复).分别对两组患者术后腹腔干处主动脉径直径增长率、不适主诉发病率、假腔血栓化发病率进行统计分析.结果 两组患者术后腹腔干处主动脉直径增长率有明显差异(P＜0.05),序贯组低于非序贯组;不适主诉发病率及假腔血栓化比例均可见明显差异(P＜0.05),序贯组优于非序贯组.结论 经过初步临床探讨,我们得出在处理Stanford B型主动脉夹层远端破口时,序贯处理优于非序贯处理.

Preliminary clinical study on distal-end tear of Stanford type B aortic dissection

Objective The objective of this article is to attempt to propose the endovascular repair principles of distal-end tear of Stanford type B aortic dissection.Methods The vascular surgery of xinjiang uygur autonomous region people's hospital received and cured 101 patients of Stanford B aortic dissection from January 2013 to January 2015.The patients are divided into two groups according different treatment principles:(1)There are 57 cases in sequential treatment group,performing endovascular repair of aortic tears from near to far,(if the tear at visceral artery is not treated then the distal-end tear is also not treated);(2) There are 44 cases in non-sequential treatment group,not performing endovascular repair of aortic tears from near to far (the tears involving visceral artery are not treated and the remaining distal-end tears are performed endovascular repair).After operation,carry out statistical analysis between two groups on the growth rate of aortic diameter of the coeliac axis,occurrence rate of main discomfort complaint,false lumen thrombosis rates.Results After operation,between the two groups,the growth rate of aortic diameter of the coeliac axis is obvious difference(P ＜ 0.05),that the sequential group is with a low rate;there are obvious differences on the occurrence rates of main discomfort complaint and false lumen thrombosis rates (P ＜ 0.05),that the sequential group is superior to the non-sequential group.Conclusions After a preliminary clinical study,we get a conclusion that when treating distal-end tears of Stanford type B aortic dissection,sequential treatment is better than non-sequential treatment.