發(fā)布時(shí)間：2018-04-29 14:40

  本文選題：急性與慢性 + Stanford��； 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的利用系統(tǒng)評(píng)價(jià)的方法比較對(duì)急性與慢性Stanford B型主動(dòng)脈夾層實(shí)施腔內(nèi)修復(fù)術(shù)(TEVAR)的臨床特點(diǎn),研究Stanford B型主動(dòng)脈夾層腔內(nèi)修復(fù)術(shù)不同手術(shù)時(shí)機(jī)的臨床特點(diǎn),為今后的臨床診治方面提供參考。方法計(jì)算機(jī)檢索檢索維普中文科技期刊全文數(shù)據(jù)庫(kù)(VIP)、中國(guó)知識(shí)資源總庫(kù)(CNKI)、萬方數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、Google學(xué)術(shù)搜素、Pubmed、德國(guó)Springer、Web of Science、Embase、Cochrane圖書館資料庫(kù)。有關(guān)急性與慢性Stanford B型主動(dòng)脈夾層腔內(nèi)修復(fù)術(shù)對(duì)比研究文獻(xiàn),采用RevMan5.3軟件進(jìn)行Meta分析。結(jié)果共納入15篇符合標(biāo)準(zhǔn)的文獻(xiàn),其中英文文獻(xiàn)7篇,中文文獻(xiàn)8篇,共包括2295例患者,其中急性期1368例,慢性期927例。通過Meta分析后結(jié)果如下:與慢性期相比,急性期患者下肢及臟器缺血發(fā)生率更高(OR=2.32,95%CI:1.60,3.38,P0.05),胸腔積液發(fā)生率更高(3.66,95%CI:2.41,5.56,P0.05),術(shù)后發(fā)生逆撕形成A型主動(dòng)脈夾層概率更高(OR=3.73,95%CI:1.26~11.4,P0.05),術(shù)后1~3年死亡率更高(OR=2.17,95%CI:1.35,3.50,P0.05),術(shù)后支架近端主動(dòng)脈假腔血栓化發(fā)生率更高(OR=1.79,95%CI:1.16~2.76,P0.05),術(shù)后支架遠(yuǎn)端假腔血栓化發(fā)生率更高(OR=1.87,95%CI:1.29~2.69,P0.05);兩組高血壓,腎功能不全,術(shù)后發(fā)生內(nèi)漏,截癱無統(tǒng)計(jì)學(xué)意義(P≥0.05)。結(jié)論Stanford B型主動(dòng)脈夾層急性期患者與慢性期患者相比術(shù)前并發(fā)癥更多,術(shù)后死亡率及并發(fā)癥更高,但是術(shù)后假腔血栓化發(fā)生率急性期患者高于慢性期患者。
[Abstract]:Objective to compare the clinical features of endovascular repair of acute and chronic Stanford B aortic dissection by means of systematic evaluation, and to study the clinical characteristics of Stanford B aortic dissection at different times. To provide reference for clinical diagnosis and treatment in the future. Methods A computer search was conducted for the full text database of Chinese scientific and technological journals in Weipu, CNKII, Wanfang, CBM, Pubmedand SpringerWeb of Science and Technology, and Cochrane Library in Germany. The literature on endovascular repair of acute and chronic Stanford B aortic dissection was analyzed by RevMan5.3 software. Results A total of 15 articles were included, including 7 in Chinese and 7 in Chinese, including 2295 patients, including 1368 in acute stage and 927 in chronic stage. The results of Meta analysis are as follows: compared with chronic stage, In acute stage, the incidence of lower limbs and viscera ischemia was higher than that of patients with acute stage. CI1: 1.603.38% P0.05, the incidence of pleural effusion was higher than 3.661% CI2.41% 5.56% P0.05, the probability of type A aortic dissection was higher after operation, the mortality rate was higher in 1 ~ 3 years after operation. The mortality rate was higher than that of 1.1795 CI-1 1.353.50% (P0.05), and the proximal end of stents had a higher probability of aortic dissection. The incidence of embolization was higher than 1.79% and 95% CI: 1.162.76% P0.05, and the incidence of thrombus in the distal end of the stent was higher than 1.8795% CI: 1.292.69% P0.050.The two groups had high blood pressure. Renal insufficiency, postoperative internal leakage, paraplegia had no statistical significance (P 鈮，

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