| 主动脉夹层诊疗进展 |
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| 引用本文： | 陈庆良,李博. 主动脉夹层诊疗进展[J]. 天津医药, 2018, 46(5): 458-461. DOI: 10.11958/20180452 |
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| 作者姓名： | 陈庆良 李博 |
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| 作者单位： | 天津市胸科医院心脏外科 （邮编300222） |
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| 摘 要： | 摘要： 主动脉夹层病情凶险, 且病死率和病残率均很高。近年来随着多种检查技术的应用, 特别是CT造影技术的发展, 使得夹层诊断率显著提高; 对该病的认识和预后的判断也随着生化检测的完善而进一步加深。根据夹层累及范围的不同, 已发展出多种成熟的手术术式, 特别是对于主动脉弓部的处理, 已由传统的象鼻支架技术演变出孙氏手术和新型三分支覆膜支架植入等, 手术的病死率和并发症发生率显著下降。主动脉覆膜支架植入术的应用将主动脉夹层的治疗由有创转向微创化发展, 但是其在影像学上有严格的限制条件。去分支手术则进一步扩大了腔内介入技术的适应证, 也使得具有手术禁忌证的患者重新获得手术机会。根据近年来主动脉夹层诊疗技术的发展,就目前主动脉夹层的早期诊断、 实验室检查、 预后评估以及治疗方法的现状进行评述, 以供基础与临床研究参考借鉴。
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| 关 键 词： | 动脉瘤 夹层 主动脉疾病 早期诊断 支架 象鼻支架 去分支手术 |
| 收稿时间： | 2018-03-27 |
| 修稿时间： | 2018-04-25 |
Progress in diagnosis and treatment of aortic dissection |
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| CHEN Qing-liang,LI Bo. Progress in diagnosis and treatment of aortic dissection[J]. Tianjin Medical Journal, 2018, 46(5): 458-461. DOI: 10.11958/20180452 |
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| Authors: | CHEN Qing-liang LI Bo |
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| Affiliation: | Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin 300222, China |
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| Abstract: | Abstract: Aortic dissection is a serious disease, and it has a high mortality and disability rates. In recent years, with the application of a variety of imaging tests, especially the development of CT imaging technology, the diagnostic rate of aortic dissection is increased significantly. The recognition and prognostic evaluation of aortic dissection also deepened with the improvement of biochemical detection. A variety of operative modes can be selected according to involved scope of aortic dissection. Especially to the therapeutic method of aortic arch department, not only traditional elephant trunk technique but also Sun’ s operation and triple-branched stent grafting can be selected. Mortality and complication rates have been dropped significantly after using new operative modes. The application of thoracic endovascular aortic repair (TEVAR) turns the invasive therapy to minimally invasive therapy for the treatment of aortic dissection. But TEVAR has strict imaging constraints. However TEVAR’ s indications are extended by debranching operation, which makes the patients with surgical contraindications to conform to the operation indication. In this article, on the basis of development of diagnosis and treatment of aortic dissection in recent years, the current early diagnosis, laboratory examination, prognostic evaluation, and the present treatment methods are summarized for reference in basic and clinical research. |
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| Keywords: | aneurysm dissecting aortic diseases early diagnosis stents elephant trunk technique debranching operation |
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