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目的总结应用腔内隔绝术治疗Stanford B型主动脉夹层经验,分析其临床特点和疗效。方法自2002年1月至2009年3月80例Stanford B型主动脉夹层患者接受腔内隔绝术治疗,对临床资料进行回顾性分析。所有患者术前接受CT血管造影或磁共振血管造影检查,术后1、6、12个月,及以后每年行胸部X线与螺旋CT或者多排CT检查,观察手术疗效以及有无内漏、移位或人工血管内支架塌陷等术后并发症。结果80例患者均成功释放支架,术后即刻造影示3例发生内漏,再次植入支架后内漏消失。术后3例围手术期死亡,无术后截瘫。随访1、3、6年的累积存活率分别为87.5%、79.4%、71.4%。结论腔内隔绝术治疗主动脉夹层创伤小,严重并发症少,住院时间短,近、中期疗效令人满意。
Objective To summarize the experience of using endovascular graft exclusion in the treatment of Stanford type B aortic dissection and to analyze its clinical features and therapeutic effects. Methods From January 2002 to March 2009, 80 patients with Stanford type B aortic dissection underwent endovascular graft exclusion. The clinical data were retrospectively analyzed. All patients underwent preoperative CT angiography or magnetic resonance angiography, postoperative 1, 6, 12 months, and every year after chest X-ray and spiral CT or multi-row CT examination to observe the surgical efficacy and whether the internal leakage, Displacement or artificial blood vessel stent collapse and other postoperative complications. Results All the 80 patients were successfully released the stent, immediately after angiography showed 3 cases of endoleaks, stent leakage again after stent implantation. Perioperative deaths occurred in 3 cases without postoperative paraplegia. The cumulative survival rates at 1, 3 and 6 years of follow-up were 87.5%, 79.4% and 71.4%, respectively. Conclusions Endovascular graft exclusion for the treatment of aortic dissection trauma, less serious complications, shorter hospital stay, near and mid-term results were satisfactory.