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对a型大动脉内壁血瘤的手术和保守治疗结果的比较

Li Yin¹, Jiankai Wang¹, Zhibing Qiu¹

¹Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, People's Republic of China.

Journal of cardiothoracic surgery

|March 6, 2024

概括

斯坦福的一种大动脉内壁血瘤 (IMH) 的手术治疗与保守管理相比,显著提高了患者的生存率. 在可行的情况下,建议作为首要选择进行手术,提供与急性大动脉解剖 (AD) 治疗相比的安全性.

科学领域:

心血管外科心血管外科
胸前大动脉疾病胸前大动脉疾病
大动脉内壁血瘤 (IMH)

背景情况:

斯坦福大学一种大动脉内壁血瘤 (IMH) 带来了临床挑战,需要各种治疗方法.
了解保守与外科治疗的比较结果对于临床决策至关重要.

研究的目的:

为了比较不同治疗方法的医院和长期临床结果,斯坦福大动脉IMH.
为选择A型IMH最佳治疗策略提供临床参考.

主要方法:

对73名A型IMH患者进行了回顾性单中心队列研究 (2018年8月至2021年8月).
患者被分为保守的 (n=26) 和手术 (n=47) 组.
同时与154名经过手术治疗的急性甲型大动脉解剖 (AD) 患者进行了比较.

主要成果:

手术IMH患者的上升大动脉直径比保守的IMH患者高 (51.22 ± 11.85毫米vs 44.92 ± 7.58毫米).
外科手术IMH组的住院死亡率较低 (0%) 与保守组相比 (11.5%).
长期死亡率在保守的IMH组 (26.1%) 与手术组 (8.5%) 相比显著更高.
在IMH组中,IMH手术的结果与AD相似,IMH组的循环停止时间和弧度参与较少.

结论:

与保守管理相比,IMH的手术治疗显著提高了患者的生存率.
在可行的情况下,应考虑手术作为斯坦福A IMH的主要治疗选择.
IMH手术的安全性与AD手术相当,尽管需要更大的样本大小来进一步验证.

关键词:

动脉剖析是一个大动脉剖析.大动脉内壁血瘤保守治疗是一种保守的治疗.长期死亡率长期死亡率进行手术治疗.

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