Stanford B型主动脉夹层腔内修复术学习曲线分析

发布时间：2018-04-13 06:44

本文选题：胸降主动脉 + 夹层　；参考：《介入放射学杂志》2017年02期

【摘要】：目的探讨介入医师对Stanford B型主动脉夹层患者实施胸主动脉夹层腔内修复术(TEVAR)的学习曲线。方法回顾性分析10年间由同一组介入医师完成的70例B型主动脉夹层TEVAR术,按手术先后次序分为A、B、C、D、E共5组,每组14例。比较各组手术时间、手术相关并发症、术后住院时间,分析不同阶段手术效果。结果 5组患者年龄、性别、分型、伴高血压、伴糖尿病、吸烟史、假腔最大直径、假腔灌注的内脏动脉及其它疾病特征比较,差异均无统计学意义(P0.05)。手术时间在A、B组分别为(3.29±0.61)h、(2.87±0.37)h(P0.05),在C、D、E组分别为(1.80±0.62)h、(1.74±0.34)h、(1.52±0.39)h(P0.05),A、B组手术时间显著长于C、D、E组(P0.001)。5组患者手术相关并发症发生率差异无统计学意义(P0.05),住院时间逐渐缩短,但无统计学意义(P0.05)。A、B组28例手术分别在6.2年、2年内完成,手术频度分别为每年3.3例、7例;B、C、D组42例手术分别在2.2年、1.2年、0.8年内完成,手术频度分别为每年6.4例、11.7例、17.5例。结论 B型主动脉夹层TEVAR术学习曲线约为28例,介入医师在每年平均4.6例手术频度下完成28例手术后手术时间明显缩短,介入医师团队手术技术明显进步。
[Abstract]:Objective to explore the learning curve of endovascular repair of Stanford B aortic dissection by interventional physicians.Methods 70 patients with type B aortic dissection performed by the same group of interventional physicians during the past 10 years were retrospectively analyzed. According to the order of operation, they were divided into 5 groups, 14 cases in each group.The operative time, postoperative complications and postoperative hospitalization time were compared in each group, and the results of operation in different stages were analyzed.Results there was no significant difference in age, sex, type, hypertension, diabetes mellitus, smoking history, maximum diameter of false lumen, splanchnic artery perfusion and other diseases in the five groups (P 0.05).But no statistical significance was found in group B (P 0.05). 28 patients in group B were operated within 6.2 years and 2 years, respectively. The frequency of operation was 3.3 cases / 7 cases per year, 42 cases in group D were completed in 2.2 years, 1.2 years and 0.8 years respectively, and the frequency of operation was 6.4 cases / 11.7 cases / 17.5 cases per year respectively.Conclusion the learning curve of TEVAR for type B aortic dissection is about 28 cases. The average operation time of interventional physician is shortened in 28 cases under the average frequency of 4.6 cases per year, and the technique of interventional team operation is improved obviously.
【作者单位】：南方医科大学南方医院介入科;
【分类号】：R654.3

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