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目的观察应用覆膜支架治疗DeBakey分型为Ⅲ型的主动脉夹层的疗效。方法患者入院后均予以胸部CT及强化CT检查,根据DeBakey分型为Ⅲ型者31例入对照组,30例入治疗组,两组均予以常规治疗,治疗组在病情稳定后予以覆膜支架置入治疗封闭夹层破口。结果治疗组30例患者,29例均成功进行了主动脉夹层腔内隔绝术,1例患者在等待手术过程中夹层破裂死亡,手术后1年有2例患者死亡;对照组31例患者在住院期间6例死亡,3例自行转上级医院行外科手术治疗,其中1例在等待手术过程中突然死亡,2例成功行外科手术,此后的1年内有13例患者死亡,两组病例相比较,P<0.001,具有高度显著性差异。结论覆膜支架腔内隔绝术治疗主动脉夹层疗效可靠,并发症少,手术成功率高,1年生存率高。
Objective To observe the curative effect of stent-graft treated with DeBakey type Ⅲ aortic dissection. Methods All patients were admitted to the hospital after chest CT and enhanced CT examination, according to DeBakey type Ⅲ type 31 cases into the control group, 30 cases into the treatment group, both groups were given conventional treatment, the treatment group was stable after stent graft Into the treatment of closed dissection break. Results Thirty patients and 29 patients in the treatment group were successfully treated with endovascular exclusion of aortic dissection. One patient died of dissection and rupture during the operation. Two patients died after one year of surgery. In the control group, 31 patients were hospitalized During the period of 6 cases died, 3 cases go to the higher level hospital for surgical treatment, including 1 case of sudden death while waiting for surgery, 2 cases of successful surgical operation, 13 cases of death within 1 year thereafter, two groups of patients, P <0.001, with a highly significant difference. Conclusions Endovascular stent-graft exclusion for the treatment of aortic dissection has reliable curative effect, less complications, high operation success rate and high 1-year survival rate.