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目的探讨超声联合CTA在Stanford A型主动脉夹层动脉瘤术后随访中的应用价值。方法回顾性分析48例经手术证实为Stanford A型主动脉夹层动脉瘤患者术前、术后临床常规资料、常规超声以及术后CTA的检查结果。结果常规超声示,与术前相比较,47例患者术后左室心腔大小、容积显著缩小,左室收缩功能显著增加(P<0.05)。2例患者颈内静脉内血栓形成。术后CTA结果显示:48例人工血管及支架血流通畅,未见吻合口瘘,1例腹主动脉段假腔内再次破裂,17例(35%)患者左肾动脉起自假腔。结论常规超声可评估Stanford A型主动脉夹层患者术后心内及颈部血管并发症、心功能情况。CTA可评估冠状动脉、肾动脉受累情况及支架吻合口情况。两者联合可对Stanford A型主动脉夹层患者术后疗效情况进行全面、真实、有效的评估,从而能有效地评估患者的病情及预后,对指导临床治疗有重要价值。
Objective To investigate the value of ultrasound combined with CTA in the follow-up of Stanford type A dissecting aneurysm. Methods The clinical data of 48 patients with Stanford type A dissecting aneurysm confirmed by surgery were retrospectively analyzed. Results of routine ultrasound and postoperative CTA were analyzed. Results Compared with preoperative ultrasound, 47 patients had significantly reduced left ventricular cavity volume, volume and left ventricular systolic function (P <0.05). 2 patients with jugular thrombosis. Postoperative CTA results showed that 48 cases of artificial blood vessels and stent blood flow, no anastomotic leakage, rupture of the abdominal aorta in 1 case and rupture of the left renal artery in 17 cases (35%). Conclusion Conventional ultrasonography can assess intracardiac and cervical vascular complications and cardiac function in patients with Stanford type A aortic dissection. CTA can assess coronary artery, renal artery involvement and stent anastomosis situation. The combination of the two can be a comprehensive, real and effective assessment of the postoperative efficacy of patients with Stanford type A aortic dissection, which can effectively evaluate the patient’s condition and prognosis, and is of great value in guiding the clinical treatment.