Stanford B型主动脉壁间血肿腔内修复术手术时机的选择

Selection of operative time for endovascular repair of Stanford type B aortic intramural hematoma

摘要:

目的 探究Stanford B型主动脉壁间血肿主动脉腔内修复术不同手术时机对手术效果、住院时间及相关并发症发生率的影响。方法 选取2017年1月—2019年12月河西学院附属张掖人民医院血管外科符合标准的Stanford B型主动脉壁间血肿的患者50例为研究对象，随机分为观察组和对照组，每组25例。观察组亚急性期（>14 d）行主动脉腔内修复术；对照组患者在急性期（≤ 14 d）行主动脉腔内修复术。比较分析两组患者手术疗效、住院时间及相关并发症发生率。结果 两组患者病死率、坠积性肺炎发生率比较，差异无统计学意义（P >0.05）；两组患者夹层逆撕率、二次干预率、Ⅰ型内漏发生率、住院时间及2周时血肿吸收率比较，差异有统计学意义（P <0.05）。结论 亚急性期对Stanford B型主动脉壁间血肿行腔内修复术具有安全有效、并发症少、二次干预率低等优点，值得在临床治疗中推广应用。

Abstract:

Objctive To explore the effect of different operation time, length of stay, and the incidence of related complications of Stanford B type aortic intramural hematoma.Methods From January 2017 to December 2019, 50 patients with Stanford B-type aortic intramural hematoma who were admitted to the vascular surgery department of Zhangye people's Hospital Affiliated to Hexi University were randomly divided into two groups: the observation group (25 cases) and the control group (25 cases). The observation group (> 14 days) underwent intraluminal repair in the subacute phase, and the control group ( ≤ 14 days) underwent intraluminal repair in the acute phase Prosthesis. Spss21.0 statistical software was used to compare and analyze the surgical efficacy, length of stay, and the incidence of related complications between the two groups.Results There was no significant difference in mortality and incidence of falling pneumonia between the two groups (P > 0.05), but there was significant difference in the rate of reverse avulsion, the rate of second intervention, the rate of type I internal leakage，the hematoma absorption rate at 2 weeks, and the length of stay (P < 0.05).Conclusion In the subacute phase, it is safe and effective to repair Stanford B type aortic intramural hematoma with less complications and low secondary intervention rate, which is worth popularizing in clinical treatment.