Stanford B型主动脉夹层远端破口处理原则的对比研究

目的 探讨Stanford B型主动脉夹层远端破口的处理原则.方法 按照不同的处理原则将Stanford B型主动脉夹层合并远端破口的患者分为两组：原则处理组：采取由近至远的原则,腔内修复远端破口,如不处理内脏动脉处破口,则也不处理其远侧破口;非原则处理组：不处理累及内脏动脉的破口,其余远端破口行腔内修复.分别对其术后不适主诉（胸背部、腰背部疼痛）发生情况、术后支架远端再破口发生情况及假腔变化情况进行分析.结果 共纳入符合标准的患者53例,其中原则处理组37例,非原则处理组16例,两组术后不适主诉发生情况及术后支架远端再破口发生情况差异无明显统计学意义（P＞0.05）,两组术后假腔变化情况差异有统计学意义（P＜0.05）.结论 原则处理组的患者预后优于非原则处理组,对于Stanford B型主动脉夹层远端多破口应按照由近至远的顺序行腔内修复,如不处理内脏动脉处破口,则也应不处理其远侧破口.

Comparative study for treatment principles of Stanford type B aortic dissection with distal crevasses

Objective To explore the treatment principle of distal crevasses in aortic dissection.Methods According to the different treatment principles of distal crevasses in aortic dissection to divide the patients into two groups：following the treatment principle group：take the principle of from near to far,endovascular repair of distal crevasses,if not deal with the crevasses involving visceral arteries,do not handle the distal crevasses; unfollowing the treatment principle group：do not deal with the crevasses involving visceral arteries,endovascular repair of it＇s distal crevasses）.Analyze the postoperative discomfort （chest and back pain,lower back pain） incidence,postoperative distal crevasses happening again and false lumen changes respectively.Results Fifty-three patients were included in the standard,in which follow the treatment principle group has 37 cases,and do not follow the treatment principle group has 16 patients.There were no significance statistically in complained of postoperative discomfort and postoperative distal crevasses happening again（P ＞ 0.05）.And there was statistically significant in the false lumen （P ＜ 0.05）.Conclusions The prognosis of patients in the following the principle treatment is better than that of unfollowing the principle group.To treat the distal crevasses in aortic dissection should be took the principle of from near to far,if not deal with the crevasses involving visceral arteries,don＇t handle the distal crevasses also.