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目的探讨主动脉夹层覆膜支架腔内修复术并发症的特点及预防处理措施。方法2001年6月至2005年5月,在我院行覆膜支架腔内修复治疗主动脉夹层78例。男性71例,女性7例,平均年龄52.7±12.3岁(31~80岁),DeBakeyⅢ型76例,DeBakeyⅠ型2例。分析术中及术后30 d内并发症的特点。结果78例患者共发生并发症15例,包括升主动脉夹层3例,发生率3.8%(3/78),分别在术中、术后第1天、第7天时发生,其中2例死于夹层破裂,心包填塞;急性肾衰2例,发生率2.6%(2/78),其中死亡1例;支架近端内漏5例,发生率6.4%(5/78);术中脑梗塞1例,发生率1.3%(1/78);术后脑出血1例,发生率1.3%(1/78),死亡;股动脉损伤1例,发生率1.3%(1/78);肱动脉假性动脉瘤、左上肢一过性缺血各1例。其中术后死亡4例,死亡率为5.1%(4/78)。结论主动脉夹层腔内修复术严重并发症发生率较高,应予以充分的重视。
Objective To investigate the characteristics of the complications of endovascular stent-graft aortic dissection and its preventive measures. Methods From June 2001 to May 2005, 78 cases of aortic dissection were treated with endovascular stent-graft in our hospital. There were 71 males and 7 females, with an average age of 52.7 ± 12.3 years (range, 31-80 years), DeBakey Ⅲ type 76 cases and DeBakey Ⅰ type 2 cases. Analysis of intraoperative and postoperative 30d complications. Results A total of 78 patients had complications in 15 cases, including ascending aortic dissection in 3 cases, the incidence of 3.8% (3/78), respectively, intraoperative, postoperative 1 day, 7 days occurred, of which 2 died of 2 cases of acute renal failure, the incidence of 2.6% (2/78), of which 1 case of death; stent leakage in 5 cases, the incidence of 6.4% (5/78); intraoperative cerebral infarction The incidence of intracerebral hemorrhage was 1.3% (1/78) in 1 case, the incidence rate was 1.3% (1/78), and the incidence of femoral artery injury was 1% (1/78) Aneurysms, left upper limb transient ischemia in 1 case. Four of them were postoperative deaths, with a mortality rate of 5.1% (4/78). Conclusions Endovascular repair of aortic dissection has a high incidence of serious complications and should be given sufficient attention.