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目的:探讨17例DeBakeyⅢ型主动脉夹层腔内修复治疗的经验和临床效果。方法:17例急性胸背痛患者经CT动脉造影(CTA)确诊为DeBakeyⅢ型主动脉夹层。依据术前CTA影像资料和数字减影血管造影(DSA)结果确认夹层破口位置,选择合适的带膜人工血管支架,在DSA监视下施行带膜人工血管支架移植术。术后1个月和术后6个月～1年行CTA检查,观察手术疗效以及有无内漏、支架移位和塌陷等术后并发症。结果:17手术成功,1例术后3d夹层进展为A型,3个月后死亡。无术后截瘫,无内漏、支架移位和塌陷发生。结论:腔内修复术治疗DeBakeyⅢ型主动脉夹层创伤小,严重并发症少,近期和中期疗效满意。
Objective: To investigate the experience and clinical effects of endovascular repair in 17 patients with DeBakey Ⅲ aortic dissection. Methods: Seventeen patients with acute chest and back pain were diagnosed as DeBakey Ⅲ aortic dissection by CT angiography (CTA). According to the results of preoperative CTA imaging and digital subtraction angiography (DSA), the location of the dissection was confirmed. The suitable angioplasty stent was selected and the DSA was performed under the surveillance of DSA. One month after operation and six months to one year after operation, CTA examination was performed to observe the effect of surgery and the complications such as internal leakage, stent displacement and collapse. Results: The operation was successful in 17 cases. One case of type 3 meningitis progressed to type A after 3 days and died after 3 months. No postoperative paraplegia, no leakage, stent displacement and collapse occurred. Conclusion: Endovascular repair of DeBakey Ⅲ aortic dissection trauma is small, less serious complications, the short-term and mid-term effect is satisfactory.