摘要
目的分析主动脉夹层患者的流行病学信息和住院期间死亡信息。方法回顾性分析2009年1至2013年12月复旦大学附属中山医院收治的主动脉夹层患者的临床资料，共1133例，其中男928例，女205例；年龄8-87岁，平均（54±13）岁。所有患者根据发病时间分为四期，分别统计各期夹层患病率，住院期间死亡率，并分组进行比较。结果接受开放手术A型夹层患者住院死亡率在超急性期（59．3％）、急性期（14．8％）和亚急性期（3．7％）呈递减趋势，差异有统计学意义（χ^2=7．93，P=0．047）；腔内治疗住院死亡率在各期比较，差异无统计学意义（χ^2=7．01，P=0．72）；保守治疗住院死亡率在各期，差异无统计学意义（χ^2=6．31，P=0．97）。B型夹层开放手术治疗住院死亡率在各期比较差异无统计学意义（χ^2=3．72，P=0．294）；腔内手术治疗住院死亡率，在超急性期、急性期、亚急性期和慢性期分别为2．6％、1．4％、0．0％和1．3％，各期比较差异无统计学意义（χ^2=3．96，P=0．260）；保守治疗住院死亡率在各期比较差异无统计学意义（χ^2=4．34，P=0．227）。结论急性A型主动脉夹层手术治疗以抢救为主要目的，但超急性期术后住院死亡率高。
Objectives To report the epidemiology and in-hospital mortality results of the thoracic aortic dissection （TAD） patients in our hospital during the last 5 years. Methods A retrospective analysis was conducted on the 1 133 TAD patients （928 male, 205 female, mean age 53.9y） from Jan 2009 to Dec 2013. We extracted the in-hospital information and performed comparisons of the in-hospital mortality within different groups by four stages and three kinds of treatments of TAD. Results The in-hospital mortality of open surgery for type A TAD was 59. 3% in superacute phase, 14. 8% in acute phase, and 3.7% in subacute phase, P = 0. 047. While in endovascular repair the mortality remained similar among different TAD phases, P = 0. 72. The treatment of Stanford type B dissection was mainly thoracic endovascular repair, the in-hospital mortalities in four stages was not significantly different, P = 0. 294. Conclusion The mortality of open surgery for acute stanford type A TAD is very high in superacute phase as a life = saving procedure.
出处
《中华普通外科杂志》
CSCD
北大核心
2015年第8期596-598,共3页
Chinese Journal of General Surgery
