本文選題：主動脈夾層 + 雜交手術(shù)��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2015年碩士論文

【摘要】：背景自1999年Dake和Nienaber等在胸主動脈內(nèi)置入覆膜支架成功修復(fù)胸主動脈夾層,Stanford B型主動脈夾層進(jìn)入了腔內(nèi)治療的全新時代。但對于主動脈弓部病變復(fù)雜的Stanford B型主動脈夾層,單純的胸主動脈腔內(nèi)覆膜支架修復(fù)術(shù)(Thoracic endovascular aortic repair, TEVAR)已不能解決問題,因此一系列輔助性的技術(shù)手段如雜交技術(shù)、煙囪技術(shù)、開窗支架、分支支架等逐漸被臨床所應(yīng)用。目前應(yīng)用較廣的是雜交技術(shù)和“煙囪”技術(shù)。我們對本中心應(yīng)用雜交技術(shù)治療Stanford B型主動脈夾層的臨床資料進(jìn)行回顧性分析以研究其臨床效果。目的本研究的目的在于分析雜交技術(shù)處理主動脈弓部病變復(fù)雜的Stanford B型主動脈夾層的臨床效果及并發(fā)癥發(fā)生情況,評估其臨床應(yīng)用價值。方法本研究為臨床病例回顧性研究,以河南省人民醫(yī)院血管外科(河南省介入治療中心外周血管介入病區(qū))自2011年1月至2014年12月收治的45例主動脈弓部病變復(fù)雜并實施雜交治療的Stanford B型主動脈夾層為研究對象,收集其住院期間的臨床資料(包括病歷資料、術(shù)前術(shù)后主動脈CTA資料、術(shù)中DSA資料)及術(shù)后隨訪資料(隨訪時間3-46個月,收集電話隨訪資料或復(fù)查的主動脈CTA資料),分析患者術(shù)后及隨訪過程中的臨床效果及并發(fā)癥發(fā)生情況。結(jié)果45例患者均成功實施雜交手術(shù),技術(shù)成功率100%。術(shù)后平均住院時間20.0天。術(shù)后住院期間共發(fā)生并發(fā)癥8例(17.8%)：其中腦卒中3例(6.7%),死亡2例(4.4%),術(shù)后造影Ⅱ型內(nèi)漏、并發(fā)肺部感染、并發(fā)逆行A型夾層各1例(各占2.2%),無截癱發(fā)生。隨訪3-46個月,平均隨訪時間21個月,隨訪率88.9%(40/45)。隨訪過程中共發(fā)生并發(fā)癥2例(4.8%)：其中1例患者死亡(2.4%),1例發(fā)生移植物感染(2.4%)。結(jié)論雜交技術(shù)治療Stanford B型主動脈夾層術(shù)后及隨訪過程中并發(fā)癥發(fā)生率低,手術(shù)效果安全可靠,但仍需警惕其部分嚴(yán)重并發(fā)癥。
[Abstract]:Background Dake and Nienaber have entered a new era of endovascular treatment since 1999 when Dake and Nienaber successfully repaired sternoaortic dissection type B aortic dissection. However, for Stanford type B aortic dissection with complicated aortic arch lesions, Thoracic endovascular aortic repair, TEVAR) can not solve the problem. Therefore, a series of auxiliary techniques such as hybrid technique, chimney technique, etc. Fenestration stents, branching stents and so on are gradually used in clinic. At present, hybrid technology and chimney technology are widely used. We retrospectively analyzed the clinical data of Stanford B aortic dissection treated by hybridization technique. Objective to analyze the clinical effects and complications of Stanford B aortic dissection with complex aortic arch lesions by hybrid technique, and to evaluate its clinical application value. Methods this study is a retrospective study of clinical cases. From January 2011 to December 2014, 45 patients with Stanford type B aortic dissection treated by vascular surgery in Henan Provincial people's Hospital from January 2011 to December 2014 were studied. The clinical data (including medical records, preoperative and postoperative CTA data, intraoperative DSA data) and follow-up data (3-46 months) were collected. The data of telephone follow-up or CTA were collected to analyze the clinical effect and complications after operation and follow-up. Results all 45 patients were successfully performed hybrid surgery, and the technical success rate was 100%. The average postoperative hospitalization time was 20.0 days. Complications occurred in 8 cases during hospitalization: stroke occurred in 3 cases (6.7%), death in 2 cases (4.4%), postoperative type 鈪，

本文編號：1977227