急性B型大動脈解剖の医療管理の結果
Anthony L Estrera1, Charles C Miller, Hazim J Safi
1Department of Cardiothoracic and Vascular Surgery, The University of Texas-Houston Medical School, Memorial Hermann Heart and Vascular Institute, 6410 Fannin St, Suite 450, Houston, Texas 77030, USA. Anthony.l.estrera@uth.tmc.edu
Circulation
|July 6, 2006
まとめ
急性B型大動脈解剖の医療管理は,病院での死亡率10.1%で,受け入れられる結果を示しています. 血管内ステントなどの他の戦略とのさらなる比較が必要である.
科学分野:
- 心血管外科手術についてです.
- 血管外科 血管外科
- 胸部外科手術について
背景:
- 急性B型大動脈解剖の最適な治療法は議論されている.
- この研究は,この状態の医療管理の初期の臨床結果について報告しています.
研究 の 目的:
- 急性B型大動脈解剖の医療管理の有効性を評価する.
- 医学的管理の結果と外科的介入の結果を比較する.
主な方法:
- 急性B型大動脈解剖患者の129人のコホートは,2001年から2005年の間に医学的に管理されました.
- 外科的介入は,破裂,膨張,perperfusion,または難治性疼痛のような特定の指示のために予約されていました.
- 患者は退院後,アウトカムを評価するためにフォローアップされた.
主要な成果:
- 病院での死亡率は全体で10.1%で,医学的に管理された患者の死亡率は8.3%,介入を必要とする患者の死亡率は19%でした.
- 罹患率は,破裂 (4.7%),脳卒中 (4.7%),パラペルジー (8.5%),腸内血症 (7%),急性腎不全 (21%),および透析の必要性 (13%) を含む.
- 病院での死亡率の独立リスク要因には,破裂が含まれ,中期死亡は,慢性肺炎症と低血球膜濾過率に関連していました.
結論:
- 急性B型大動脈解剖の医学的管理は,許容可能な早期の結果と関連しています.
- これらの結果を,血管内ステントなどの代替戦略と比較するためにさらなる研究が必要である.
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