文章摘要
韩国富,魏凯凯,卞朝艺,等.原位开窗和体外预开窗技术治疗Stanford B型主动脉夹层的效果对比[J].中国临床保健杂志,2026,29(4):542-545.
原位开窗和体外预开窗技术治疗Stanford B型主动脉夹层的效果对比
Comparison of the effects of in situ fenestration and in vitro pre-fenestration techniques in the treatment of Stanford B type aortic dissection
投稿时间：2026-03-06  
DOI：10.3969/J.issn.1672-6790.2026.04.020
中文关键词: 动脉瘤腔内修复术  主动脉夹层  锁骨下动脉  预后
英文关键词: Endovascular aneurysm repair  Aortic dissection  Subclavian artery  Prognosis 〖FL
基金项目:
作者单位E-mail
韩国富 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
魏凯凯 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
卞朝艺 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
马强强 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
张凯 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
马龙 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
孔令尚 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
万圣云 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
王文斌 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
刘光 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
秦金保 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
陆信武 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
叶琨 安徽医科大学第二附属医院血管外科,合肥 230601 efy120435@fy.ahmu.edu.cn 
摘要点击次数: 82
全文下载次数: 52
中文摘要:
      目的 探讨原位开窗与体外预开窗技术在腔内治疗累及左锁骨下动脉的Stanford B型主动脉夹层的短期及中期疗效与安全性。方法 回顾性分析2019年4月至2025年7月在安徽医科大学第二附属医院运用开窗技术重建左锁骨下动脉的69例Stanford B型主动脉夹层患者的临床及随访资料。其中原位开窗组26例,体外预开窗组43例,评估其临床疗效、围手术期和随访期并发症发生情况。结果 原位开窗组及体外预开窗组手术成功率均为100%。两组在手术时间、夹层类型、左锁骨下动脉近端主动脉直径、左锁骨下动脉直径及角度、主动脉弓型、主体及分支支架直径、造影剂用量和oversize等方面比较,差异均无统计学意义(均P>0.05)。随访半年内,体外预开窗组2例Ⅱ型内漏,1例Ⅲ型内漏,1例术后1 d出现截瘫。在随访满12个月的亚组中,术后一年两组各出现1例腹主动脉夹层动脉瘤,经手术干预后均获得良好疗效。两组在术后主要并发症及再干预率方面比较,差异均无统计学意义(均P>0.05)。多因素回归分析显示,开窗手术与并发症发生无相关性。结论 原位开窗与体外预开窗技术均有较高的手术成功率、较低的围手术期死亡率和并发症发生率,临床短期与中期预后良好,两者整体效果相近。
英文摘要:
      Objective To explore the short-term and mid-term efficacy and safety of in situ fenestration and in vitro pre-fenestration techniques in the endovascular treatment of Stanford B type aortic dissection involving the left subclavian artery.Methods A retrospective analysis was conducted on the clinical and follow-up data of 69 patients with Stanford type B aortic dissection who underwent left subclavian artery revascularization via fenestration techniques at the Second Affiliated Hospital of Anhui Medical University between April 2019 and July 2025.Patients were stratified into the in situ fenestration group(n=26) and the in vitro pre-fenestration group(n=43).Clinical outcomes,perioperative and follow-up complications were evaluated.Results The technical success rate was 100% in both the in situ fenestration group and the in vitro pre-fenestration group.No statistical differences were observed between the two groups in terms of operation time,dissection type,proximal aortic diameter of the left subclavian artery,left subclavian artery diameter,left subclavian artery angle,aortic arch type,main stent diameter,branch stent diameter,contrast agent dosage or oversize (all P＞0.05).Within 6 months of follow-up,2 cases of type Ⅱ endoleak,1 case of type Ⅲ endoleak and 1 case of paraplegia (occurring 1 day postoperatively) were recorded in the in vitro pre-fenestration group.Among patients with follow-up duration ≥12 months,one case of abdominal aortic dissection aneurysm occurred in each group at 1 year postoperatively,both cases achieved favorable outcomes after surgical intervention.There were no statistical differences between the two groups in terms of major postoperative complications or reintervention rate(all P＞0.05).Multivariate regression analysis revealed that fenestration technique was not associated with the development of complications.Conclusions Both in situ fenestration and in vitro pre-fenestration techniques have demonstrated high surgical success rates,low perioperative mortality and complication rates,and good short-and medium-term clinical outcomes.The overall effects of the two techniques are similar.
查看全文     
关闭