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观察和等待策略用于A型室内血瘤的选定患者
Tadashi Kitamura1, Masaomi Fukuzumi2, Toshiaki Mishima2
1Department of Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan. funcorogash@hotmail.com.
General thoracic and cardiovascular surgery
|August 17, 2023
概括
一种保守的观察和等待方法用于选择A型室内血瘤患者,显示出有利的结果. 这一策略没有导致主动脉相关的死亡,证明了其在特定患者队列中的安全性和有效性.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 胸部外科手术 胸部外科手术
背景情况:
- 一种类型的室内血瘤 (IMH) 是一种类型的大动脉剖析的变体.
- 对A型IMH的管理策略各不相同,需要确定最佳治疗途径.
研究的目的:
- 评估A型IMH的观察和等待策略的早期和中期结果.
- 在选定的患者中,比较观察和等待和紧急手术修复之间的结果.
主要方法:
- 连续100名患有A型IMH的患者的回顾性分析.
- 观察和等待标准:最大大动脉直径<50毫米,疼痛分数<3/10,没有类似的投射.
- 主要终点:所有原因和与大动脉相关的死亡;次要终点:大动脉事件.
主要成果:
- 52名患者接受了观察和等待; 48人接受了紧急修复.
- 两组之间在住院死亡率,5年生存率或5年无主动脉相关死亡率方面没有显著差异.
- 观察和等待组:5年无大动脉事件的自由率为60%.
结论:
- 观察和等待策略有利于符合特定标准的A型IMH患者 (直径≤50毫米,疼痛≤3/10,没有状投射).
- 这种方法在研究队列中没有导致主动脉相关的死亡.
- 早期和中期的结果支持观察和等待作为选择A型IMH病例的安全管理选项.
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