腔内修复或药物治疗稳定型B型主动脉夹层

发布时间：2018-06-13 01:45

本文选题：胸降主动脉 + 夹层　；参考：《介入放射学杂志》2017年03期

【摘要】：目的比较胸主动脉腔内修复术(TEVAR)联合药物及单纯药物在稳定型Standford B型主动脉夹层治疗中的价值,探讨稳定型B型主动脉夹层治疗策略。方法回顾性分析2004年至2015年收治的118例明确诊断为稳定型B型主动脉夹层患者临床资料,其中接受TEVAR联合药物治疗(TEVAR组)57例,单纯药物治疗(药物组)61例。分别统计1个月内、随访期并发症和死亡率,Kaplan-Meier生存曲线比较两组生存率。结果术后1个月内及住院期间主要并发症发生率、死亡率,TEVAR组分别为5.2%、0%,药物组均为0%。术后随访1~110个月,平均(43.3±36.7)个月,主要并发症、死亡率在TEVAR组分别为7.0%、5.3%,药物组分别为6.6%、8.1%;术后1、2、4、7年累积生存率在TEVAR组分别为100%、97.1%、93.5%、78.0%,药物组分别为98.4%、96.4%、90.8%、72.7%,两组间差异无统计学意义(χ2=0.019,P=0.890)。结论与单纯药物治疗相比,TEVAR术治疗稳定型Standford B型主动脉夹层可降低假腔扩展率,但有手术相关并发症,并不能提高生存率。
[Abstract]:Objective to compare the value of TEVARs combined with drugs alone in the treatment of stable type B aortic dissection and to explore the treatment strategy of stable type B aortic dissection. Methods the clinical data of 118 patients with stable type B aortic dissection from 2004 to 2015 were retrospectively analyzed. Among them, 57 cases were treated with TEVAR combined with drug therapy, and 61 cases were treated with drugs alone. The survival rates of the two groups were compared by Kaplan-Meier survival curve. Results the incidence of major complications within 1 month after operation and during hospitalization was 5.2g in TEVAR group and 0 in drug group. The main complications were 7.0and 5.3in TEVAR group, 6.6and 8.1respectively in the drug group, and the accumulative survival rate in the TEVAR group was 100, 97.193.58.0in the TEVAR group, and in the drug group 98.496.40.90.80.There was no significant difference between the two groups (蠂 _ 2 0.019P ~ (0.890). Conclusion compared with the drug therapy alone, the treatment of stable Stanford B aortic dissection can reduce the rate of pseudolumen expansion, but it can not improve the survival rate because of the complications associated with surgery.
【作者单位】：南方医科大学南方医院介入放射科;
【分类号】：R543.1

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