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目的分析Stanford B型主动脉夹层(AD)急性期行主动脉腔内修复术(TEVAR)的疗效。方法回顾性分析2010年6月至2016年7月酒泉市人民医院与兰州大学第一医院收治的261例Stanford B型AD患者的临床资料,其中246例患者均在急性期行TEAVR。结果急性期Stanford B型AD手术246例,手术时间均在发病1~7 d内,TEAVR的成功率为100%。术后30 d内2例发生Ⅰ型内漏,发生率为0.81%;死亡3例,死亡率为1.22%。其他患者于术后3 d,术后1、3、6个月和术后1年复查计算机体层摄影血管造影(CTA),未见手术相关并发症。结论术前对病变进行充分评估,制定个体化治疗方案,术中精细操作,在Stanford B型AD动脉瘤急性期行TEVAR手术是安全、有效的方案。
Objective To analyze the curative effect of aortic endovascular repair (TEVAR) in Stanford type B aortic dissection (AD). Methods Clinical data of 261 patients with Stanford type B AD admitted to Jiuquan Municipal People’s Hospital and Lanzhou University First Hospital from June 2010 to July 2016 were retrospectively analyzed. Of the 246 patients, TEAVR was performed in acute phase. Results In the acute period, 246 cases of Stanford type B AD were operated. The operation time was within 1 to 7 days and the success rate of TEAVR was 100%. Type I endoleak occurred in 2 patients within 30 days after operation, with a rate of 0.81%; 3 died and the death rate was 1.22%. Other patients underwent computed tomography angiography (CTA) at 3 days, 1, 3, 6 months and 1 year after operation. There were no operative complications. Conclusion Preoperative assessment of the disease, to develop individualized treatment programs, fine operation, Stanford B type AD aneurysm in the acute phase of TEVAR surgery is a safe and effective program.