摘要
目的观察胸主动脉腔内修复术(TEVAR)在Stanford B型主动脉夹层治疗中的应用效果及其长期疗效。方法回顾性选取2016年3月至2019年3月文山州人民医院收治的100例Stand ford B型主动脉夹层患者为观察对象,按照治疗方法不同将其分为对照组(n=50)与治疗组(n=50),对照组予以患者传统开放式手术治疗;治疗组给予患者实施TEVAR术治疗。观察对比2组院内治疗效果,总结2组的随访与术后生存情况。结果治疗组患者的院内病死率(8.00%)明显低于对照组(20.00%),差异有统计学意义(P<0.05);治疗组术后的并发症总发生率(13.04%)明显低于对照组(35.00%),差异有统计学意义(P<0.05);治疗组患者术后出院30 d的病死率(0)明显低于对照组(10.00%),差异有统计学意义(P<0.05);治疗组术后随访0.5年、1年的生存率(97.83%,86.96%),与对照组(94.44%,86.11%)比较,差异无统计学意义(P>0.05);治疗组术后随访2年的生存率(84.78%)明显高于对照组(72.00%),差异有统计学意义(P<0.05)。结论TEVAR术治疗Stanford B型主动脉夹层相较于传统开放式手术,治疗效果更好,远期生存率更高,并发症少进而提高安全性,该术式值得深入研究,能够为临床提供有价值的参考。
Objective To observe the effect and long-term effect of thoracic aortic endovascular repair(TEVAR)in the treatment of Stanford B-type aortic dissection.Methods A total of 100 patients with standford Type B aortic dissection admitted to The People's Hospital of Wenshan Prefecture were retrospectively conducted from March 2016 to March 2019.According to the treatment methods,they were divided into control group(50 cases)and treatment group(50 cases),and the control group received traditional open surgical treatment.Patients in the treatment group were treated with TEVAR,the results of in-hospital treatment in the two groups were observed and compared,and the follow-up and postoperative survival of the two groups were summarized.Results The nosocomial mortality in the treatment group(8.00%)was significantly lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the treatment group(13.04%)was lower than that in the control group(35.00%),and the difference was statistically significant(P<0.05).The mortality rate of patients in the treatment group(0)was significantly lower than that of the control group(10.00%)at 30 days after discharge after surgery,with a statistically significant difference(P<0.05).The survival rates of the treatment group after 0.5 year follow-up and 1 year follow-up were 97.83%and 86.96%,respectively,compared with 94.44%and 86.11%of the control group,the difference was not statistically significant(P>0.05).The 2-year survival rate after postoperative follow-up in the treatment group(84.78%)was significantly higher than that in the control group(72.00%),and the difference was statistically significant(P<0.05).Conclusion Compared with traditional open surgery,TEVAR in the treatment of Stanford Type B aortic dissection has good therapeutic effect,high long-term survival rate,fewer complications and improved safety.This operation is worthy of in-depth study and can provide valuable reference for clinical practice.
作者
吴兴建
李应菊
尚中忍
张思源
WU Xing-jian;LI Ying-ju;SHANG Zhong-ren(Department of Cardiothoracic Vascular Surgery,The People's Hospital of Wenshan Prefecture,Wenshan Yunnan 663099,China)
出处
《临床和实验医学杂志》
2021年第7期731-734,共4页
Journal of Clinical and Experimental Medicine
基金
云南省教育厅科学研究基金项目(编号:2017ZDX102)
文山州卫生和计划生育委员会科研项目(编号:wszwjw201701)。
