马洺远 林纲毅 刘文亚

【摘要】 目的：分析覆膜支架腔內修复术对Stanford B型主动脉夹层动脉瘤患者生存率的影响。方法：回顾性分析2015年10月-2017年1月笔者所在医院收治的72例Stanford B型主动脉夹层动脉瘤患者，将采用药物保守治疗的36例患者作为药物组，将采用覆膜支架腔内修复术治疗的36例患者作为介入术组。对比两组治疗前后急性生理与慢性健康评分表（APACHEⅡ）评分、肝肾功能[谷丙转氨酶（ALT）、尿素氮（BUN）]，统计两组治疗后12、36个月生存率。结果：治疗后介入术组APACHEⅡ评分低于药物组，差异有统计学意义（P<0.05）;治疗后介入术组血清ALT、BUN水平均低于药物组，差异均有统计学意义（P<0.05）;介入术组治疗后12、36个月生存率（100%、88.89%）均高于药物组（80.56%、41.67%），差异均有统计学意义（P<0.05）。结论：覆膜支架腔内修复术治疗Stanford B型主动脉夹层动脉瘤患者可减轻疾病严重程度，改善肝肾功能，提高生存率。

【关键词】 覆膜支架腔内修复术 Stanford B型主动脉夹层动脉瘤 肝肾功能 急性生理与慢性健康评分 生存率

doi：10.14033/j.cnki.cfmr.2020.20.014 文献标识码 B 文章编号 1674-6805（2020）20-00-03

The Effect of Stent-covered Endovascular Repair on the Survival Rate of Patients with Stanford Type B Aortic Dissecting Aneurysm/MA Mingyuan， LIN Gangyi， LIU Wenya. //Chinese and Foreign Medical Research， 2020， 18（20）： -40

[Abstract] Objective： To analyze the effect of stent-covered endovascular repair on the survival rate of patients with Stanford type B aortic dissecting aneurysm. Method： A retrospective analysis was performed on 72 patients with Stanford type B aortic dissecting aneurysm in our hospital from October 2015 to January 2017. The 36 patients who received drug conservative treatment were taken as the drug group， and the 36 patients who received stent-covered endovascular repair were taken as the interventional treatment group. The acute physiology and chronic health assessment （APACHE Ⅱ） score， liver and kidney function [Alanine aminotransferase （ALT）， urea nitrogen （BUN）] before and after the treatment between the two groups were compared， the survival rate at 12 and 36 months after treatment was calculated. Result： After treatment， the APACHE Ⅱ score in the interventional treatment group was lower than that in the drug group， the difference was statistically significant （P<0.05）. After treatment， the serum ALT and BUN levels in the interventional treatment group were lower than those in the drug group， the differences were statistically significant （P<0.05）. The survival rates at 12 months after treatment and 36 months after treatment in the interventional treatment group were 100% and 88.89%， higher than 80.56% and 41.67% in the drug group， the differences were statistically significant （P<0.05）. Conclusion： The treatment of Stanford type B aortic dissecting aneurysms with stent-covered endovascular repair can reduce the severity of the disease， improve liver and kidney function， and improve the survival rate.

[Key words] Stent-covered endovascular repair Stanford type B aortic dissecting aneurysm Liver and kidney function Acute physiological and chronic health scores Survival rates

First-authors address： Shantou Central Hospital， Shantou 515041， China

主动脉夹层动脉瘤属于危重心血管病变，指主动脉腔内血液通过内膜破口进入主动脉壁中层形成血肿，临床症状以皮肤苍白、气促、胸部剧烈疼痛、脉弱等为主，若未得到及时有效治疗，易并发胸腔积血、心包积血等，危及生命[1-2]。根据Stanford法分型未累及升主动脉病变为Stanford B型主动脉夹层动脉瘤，临床针对其主要采取药物保守治疗、介入手术治疗，但针对何为最佳治疗方案临床尚存一定争议。基于此，本研究对笔者所在医院收治的72例Stanford B型主动脉夹层动脉瘤患者进行回顾性分析，探讨覆膜支架腔内修复术的应用价值，报告如下。

1 资料与方法

1.1 一般资料

本研究回顾性分析2015年10月-2017年1月笔者所在医院收治的72例Stanford B型主动脉夹层动脉瘤患者。纳入标准：均经数字剪影血管造影（DSA）、超声心动图、血常规及临床确诊为Stanford B型主动脉夹层动脉瘤，首次发病，无颅内等其他严重病变。……