摘要
目的 比较急、慢性期主动脉夹层行腔内隔绝术的临床疗效.方法 分析沈阳军区总医院心内科2002年5月至2010年2月由于B型主动脉夹层住院患者的临床和影像资料,其中处于急性期的115例,处于慢性期的63例.经股动脉置入覆膜支架封堵胸主动脉破裂口,分析其临床特点、近期及远期疗效.结果 与慢性主动脉夹层组相比,急性主动脉夹层组胸腔积液（13.0%比1.6%,P=0.01）、肢体或内脏缺血（18.3%比3.2%,P〈0.01）、D2聚体〉0.5 mg/L（97.4%比33.3%,P〈0.01）、C反应蛋白〉8 mg/L（93.9%比30.2%,P〈0.01）发生率较高;近期并发症发生率较高（31.3%比14.3%,P=0.01）.出院后对患者进行了（30.8±21.9）个月随访,两组远期并发症发生率差异无统计学意义（7.8%比4.8%,P=0.44）.Kaplan-Meier曲线提示,两组长期无事件生存率差别无统计学意义（Log Rank,P=0.46）,其中急性主动脉夹层组5年无事件生存率为80.0%,慢性主动脉夹层组5年无事件生存率为82.5%.结论 腔内隔绝术治疗B型主动脉夹层安全有效,急性主动脉夹层组较慢性主动脉夹层组并发症增多,但两组随访期内死亡率并无差别.
Objective To compare the clinical results of percutaneous transluminal stenting in the treatment of patients with acute and chronic aortic dissections. Methods From May 2002 to February 2010, 115 patients with acute type B aortic dissection and 63 patients with chronic aortic dissection underwent stenting. The clinical data of the patients were analyzed. Results Comparing with chronic aortic dissection group, acute aortic dissection group had higher percentage of thoracic cavity effusion （13.0% vs 1.6%,P=0.01 ）, visceral/leg ischemia （18.3% vs 3.2%, P〈0.01）,D-Dimer （D-D） 〉0.5 mg/L （97.4% vs 33.3%, P〈0.01）and C-reactive protein 〉8 mg/L（93.9% vs 30.2%, P〈0.01 ）. Acute aortic dissection group had higher complications in early term （31.3% vs 14.3% ,P=0.01 ）. All patients were followed up for an average of （30.8±21.9） months. The rate of complications were no difference in patients with acute aortic dissection than those with chronic aortic dissection （7.8% vs 4.8%, P=0.44）. Kaplan-Meier analysis showed no differences of survival rate between 2 groups during follow-up periods （Log Rank,P=0.46）. The survival rate in acute aortic dissection group was 80.0% at 5 years, and 82.5% at 5 years in chronic aortic dissection group. Conclusion Percutaneous transluminal stenting was effective in the treatment of type B aortic dissection, there are more complications in acute aortic dissection group than chronic aortic dissection group. The survival rate has no difference in two groups in follow-up period.
出处
《中国心血管病研究》
CAS
2010年第11期817-820,共4页
Chinese Journal of Cardiovascular Research
关键词
夹层
腔内隔绝术
并发症
Dissection
Percutaneous transluminal stenting
Complication
