介入放射学杂志2024,Vol.33Issue(8) :839-843.DOI:10.3969/j.issn.1008-794X.2024.08.005

主动脉近端破口腔内隔绝术治疗A型主动脉壁内血肿伴心包积液近期效果观察

Endovascular isolation of proximal aortic intimal rupture for the treatment of type A aortic intramural hematoma with pericardial effusion:observation of short-term efficacy

张胜康 尹晓清 徐朝军 王兆礼 杨进 程宇
介入放射学杂志2024,Vol.33Issue(8) :839-843.DOI:10.3969/j.issn.1008-794X.2024.08.005

主动脉近端破口腔内隔绝术治疗A型主动脉壁内血肿伴心包积液近期效果观察

Endovascular isolation of proximal aortic intimal rupture for the treatment of type A aortic intramural hematoma with pericardial effusion:observation of short-term efficacy

张胜康 1尹晓清 1徐朝军 1王兆礼 1杨进 1程宇1
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作者信息

  • 1. 410007 湖南长沙 湖南中医药大学第一附属医院心胸外科
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摘要

目的 观察腔内隔绝治疗A型主动脉壁内血肿(AIH)伴心包积液的近期效果,探讨A型AIH伴心包积液腔内隔绝治疗策略.方法 选取湖南中医药大学第一附属医院2018年2月至2021年11月收治的12例A型AIH伴心包积液患者.所有患者术前升主动脉内膜均完整,主动脉弓部或胸降主动脉近端内膜有破口,均接受腔内隔绝术封闭治疗.4例发病1周内手术,8例保守治疗1周后择期手术,术后随访12个月.结果 发病1周内手术患者术后1例恢复顺利,2例术后3个月内出现A型夹层,1例早期死亡;保守治疗1周后手术8例患者均恢复顺利.结论 A型AIH伴少至中量心包积液患者经保守治疗减轻升主动脉血肿后,择期行腔内隔绝治疗的效果理想.

Abstract

Objective To explore the short-term efficacy of endovascular isolation treatment for type A aortic intramural hematoma(AIH)with pericardial effusion,and to discuss the endovascular isolation treatment strategy for type A AIH with pericardial effusion.Methods A total of 12 patients with type A AIH complicated by pericardial effusion,who were admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China between February 2018 and November 2021,were enrolled in this study.Before surgery,the intima of the ascending aorta was intact in all patients,but a rupture at the proximal intima of the aortic arch or the thoracic descending aorta was detected.All patients received endovascular isolation treatment.Among them,4 patients received endovascular isolation treatment within one week after the onset of disease,and 8 patients received selective operation after receiving conservative treatment for one week.The patients were followed up for one year.Results Among the patients who received endovascular isolation treatment within one week after the onset of disease,one patient recovered smoothly,two patients developed type A dissection within 3 months after surgery,and one died early after surgery.All the 8 patients,who received selective operation after receiving conservative treatment for one week,recovered smoothly.Conclusion For patients with type A AIH complicated by mild to moderate pericardial effusion,selective endovascular isolation treatment after receiving the conservative treatment to alleviate the ascending aortic hematoma can achieve ideal therapeutic effect.

关键词

主动脉壁内血肿/腔内隔绝术/保守治疗/心包积液

Key words

aortic intramural hematoma/endovascular isolation/conservative treatment/pericardial effusion

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基金项目

湖南省教育厅科学研究项目(20A364)

出版年

2024
介入放射学杂志
上海市医学会

介入放射学杂志

CSTPCDCSCD北大核心
影响因子:1.866
ISSN:1008-794X
参考文献量24
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