[1]王志伟,王家祥,李 震,等. 无钙化B型主动脉壁间血肿的治疗[J].介入放射学杂志,2014,(03):210-213.
 WANG Zhi? wei,WANG Jia? xiang,LI Zhen,et al. Conservative treatment of type B aortic intramural hematoma with no calcification[J].journal interventional radiology,2014,(03):210-213.
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年03期
页码:
210-213
栏目:
血管介入
出版日期:
2014-03-25

文章信息/Info

Title:
 Conservative treatment of type B aortic intramural hematoma with no calcification
作者:
 王志伟 王家祥 李 震 管 生 王雷永
Author(s):
 WANG Zhi?蛳 wei WANG Jia?蛳 xiang LI Zhen GUAN Sheng WANG Lei?蛳 yong.
 Department of Endovascular, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
关键词:
 【关键词】 主动脉夹层 壁间血肿 钙化斑 治疗 随访
文献标志码:
A
摘要:
【摘要】 目的 探讨病变段主动脉壁无钙化斑的Stanford B型主动脉壁间血肿患者保守治疗效果和中期随访结果。方法 2009年3月—2012年3 月收治21例主动脉壁无钙化斑的Stanford B型主动脉壁间血肿患者,均经64排全主动脉CTA扫描确诊病变段。对21例患者均采用药物治疗,并进行1年随访,在3、6个月及1年时复查主动脉CTA。结果 21例患者中,1例药物治疗1周后行主动脉腔内修复术治疗,余20例全程药物治疗,均无症状出院。21例患者无失访病例,且均存活,随访期间无症状复发患者。随访3个月时,11例左侧胸腔积液均完全吸收,3例患者壁间血肿完全吸收。随访6个月时,13例患者壁间血肿完全吸收。随访1年时,19例壁间血肿完全吸收,余2例壁间血肿厚度及范围均明显减少。结论 对于Stanford B型主动脉壁间血肿患者病变段主动脉壁有无钙化斑容易判断,对无钙化斑的患者进行严格的保守治疗疗效满意,中期随访结果良好。

参考文献/References:

 [1] 张学民, 李清乐, 李 伟, 等. 主动脉壁间血肿的诊断和治疗[J]. 中华普通外科杂志, 2008, 23: 639 ?蛳 641.
[2] Erbel R, Alfonso F, Boileau C, et al. Diagnosis and management of aortic dissection[J]. Eur Heart J, 2001, 22: 1642 ?蛳 1681.
[3] Sawaki S, Hirate Y, Ashida S, et al. Clinical outcomes of medical treatment of acute type A intramural hematoma[J]. Asian Cardiovasc Thorac Ann, 2010, 18: 354 ?蛳 359.
[4] Sundt TM. Intramural hematoma and penetrating atherosclerotic ulcer of the aorta[J]. Ann Thorac Surg, 2007, 83: S835 ?蛳 S841.
[5] Vilacosta I, Aragoncillo P, Ca?觡adas V, et al. Acute aortic syndrome: a new look at an old conundrum[J]. Heart, 2010, 86: 52 ?蛳 61.
[6] 王朴飞, 吕 梁. 主动脉壁间血肿、 穿透性粥样硬化性主动脉溃疡和主动脉夹层: 影像学表现和发病机制进展[J]. 中国介入影像与治疗学, 2011, 8: 148 ?蛳 151.
[7] Eggebrecht H, Plicht B, Kahlert P, et al. Intramural hematoma and penetrating ulcers: indications to endovascular treatment[J]. Eur J Vasc Endovasc Surg, 2009, 38: 659 ?蛳 665.
[8] Evangelista A, Eagle KA. Is the optimal management of acute type a aortic intramural hematoma evolving?[J]. Circulation, 2009, 120: 2029 ?蛳 2032.
[9] 蒋俊豪, 季瀛豪, 郭大乔, 等. 急性Stanford B型主动脉夹层腔内修复术的指证和治疗时机选择[J]. 中华外科杂志, 2009, 47: 1784 ?蛳 1786.
[10] Finn JP, Nael K, Deshpande V, et al. Cardiac Mr imaging: state of the technology[J]. Radiology, 2006, 241: 338 ?蛳 354.
[11] 何庚戌, 周 峰, 濮仁富,等. Standford B型主动脉壁间血肿的治疗[J]. 中国胸心血管外科临床杂志, 2011, 18: 361.
[12] Ganaha F, Miller DC, Sugimoto K, et al. Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis[J]. Circulation, 2002, 106: 342 ?蛳 348.
[13] Grimm M, Loewe C, Gottardi R, et al. Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta[J]. Ann Thorac Surg, 2008, 86: 453 ?蛳 456.
[14] Gore I. Pathogenesis of dissecting aneurysm of the aorta[J]. AMA Arch Pathol,1952,53: 142 ?蛳 153.
[15] Pelzel JM, Braverman AC, Hirsch AT, et al. International heterogeneity in diagnostic frequency and clinical outcomes of ascending aortic intramural hematoma[J]. J Am Soc Echocardiogr, 2007, 20: 1260 ?蛳 1268.
[16] Stanson AW, Kazmier FJ, Hollier LH, et al. Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations[J]. Ann Vasc Surg, 1986, 1: 15 ?蛳 23.
[17] 郗二平, 朱水波, 王荣平, 等. 11例主动脉壁间血肿临床观察研究[J]. 中国医师进修杂志, 2009, 32: 71 ?蛳 72.
[18] Kitai T, Kaji S, Yamamuro A, et al. Impact of new development of ulcer?蛳 like projection on clinical outcomes in patients with type B aortic dissection with closed and thrombosed false lumen[J]. Circulation, 2010, 122: S74 ?蛳 S80.
[19] Li DL, Zhang HK, Cai YY, et al. Acute type B aortic intramural hematoma: treatment strategy and the role of endovascular repair[J]. J Endovasc Ther, 2010, 17: 617 ?蛳 621.
[20] 巍以桢, 吕 滨, 支爱华, 等. 主动脉壁内血肿的临床分型及中期随访结果[J]. 中国循环杂志, 2010, 25: 205 ?蛳 207.

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备注/Memo

备注/Memo:
 (收稿日期:2013-08-17)

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