| 摘要: |
| ［摘要］ 目的 总结Stanford B型主动脉夹层局麻下支架植入的治疗经验。方法 回顾性分析2017-05～2019-05该院实施的32例B型主动脉夹层局麻下行胸主动脉覆膜支架腔内修复术（thoracic endovascular aortic repair，TEVAR)的病历资料，总结治疗经验。结果 32例均顺利完成手术。术中1例出现少量Ⅰ型内漏。无死亡病例，无重大心脑血管意外发生。随访6.4～10.5个月，1例术后6个月复查时发现远端支架膨出，再次植入支架1枚后治愈。结论 主动脉夹层经过术前的精心准备、评估、测量，可局麻下实行Stanford B型主动脉夹层的TEVAR治疗。通过改良腹股沟横切口或经皮穿刺代替纵切口，以及围手术期精心护理，可显著减少术中、术后并发症的发生。 |
| 关键词: 局部麻醉 分支支架 主动脉夹层 快速康复 |
| DOI：10.3969/j.issn.1674-3806.2020.06.13 |
| 分类号:R 615 |
| 基金项目:广西卫健委科研课题（编号：Z20180101） |
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| Treatment experience of stent implantation under local anesthesia in 32 patients with Stanford type B aortic dissection |
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SUN Yu-gui, ZHANG Li-fei, XIAO Zhi-hong
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Department of Cardiovascular Surgery, the Second Affiliated Hospital of Guilin Medical University, Guangxi 541199, China
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| Abstract: |
| ［Abstract］ Objective To summarize the treatment experience of stent implantation for Stanford type B aortic dissection under local anesthesia. Methods The data of medical records of 32 cases of type B aortic dissection who received thoracic endovascular aortic repair(TEVAR) in our hospital From May 2017 to May 2019 were retrospectively analyzed to summarize the treatment experience. Results The operation was successfully completed in all the 32 cases. During the operation, a small amount of type Ⅰ endoleak occurred in 1 case, but no deaths and no major cardiovascular and cerebrovascular accidents occurred. The patients were followed up for 6.4 to 10.5 months. One patient had distal stent bulging 6 months after the operation and was cured by reimplantation of one stent. Conclusion After careful preparation, evaluation and measurement of aortic dissection, TEVAR under local anesthesia for Stanford type B aortic dissection can be performed, and the occurrence of intraoperative and postoperative complications can be significantly reduced through the improvement of transverse inguinal incision or percutaneous puncture instead of longitudinal incision, as well as careful perioperative nursing. |
| Key words: Local anesthesia Branch stent Aortic dissection Rapid rehabilitation |
