目的：探讨腔内修复手术与药物保守治疗急性 stanford B型主动脉夹层患者的临床疗效和安全性。方法将82例急性stanford B型主动脉夹层患者按随机数字表法分为观察组与对照组，每组41例。观察组采用腔内修复手术治疗，对照组予以药物保守治疗，治疗后随访12个月。比较两组CT血管造影复查结果，生存率，并发症及不良反应发生率。结果治疗后CT血管造影复查发现，观察组假腔血栓化及假腔消失率显著高于对照组（P＜0．01），假腔增大、假腔无变化率均显著低于对照组（P＜0．01）。随访各时点两组生存率比较差异均无显著性（P＞0．05）。两组各种并发症及不良反应发生率比较差异无显著性（P＞0．05）。结论腔内修复手术与药物治疗急性stanford B型主动脉夹层均有一定疗效，两者生存率基本相当，但手术干预可提高假腔血栓化及假腔消失率，有更高的临床价值。%Objective To explore the efficacy and safety of endovascular repair and drug conservative treat‐ment of acute stanford type B aortic dissection (STBAD ) .Methods Eighty‐two acute STBAD patients were randomly assigned to observation and control group of 41 ones each .Observation group received en‐dovascular repair and control group did drug conservative treatment ,they were followed up for 12 months after treatment .CTA reexamination results ,survival rates ,the incidences of complications and adverse re‐actions were compared between 2 groups . Results CTA reexaminations showed that pseudoalveolus thrombosis and pseudoalveolus disappearance rate were significantly higher (P<0 .01) and pseudoalveolus enlargement and pseudoalveolus non‐change lower (P<0 .01) in observation than in control group .There were no significant group differences in survival rates at each point of follow‐up (P>0 .05) .There were no significant group differences in the incidences of complications and adverse reactions and total incidence (P>0 .05) .Conclusion Endovascular repair and pharmacotherapy have a certain effect on STBAD ,their survival rates are basically equivalent ,but operative intervention could boost pseudoalveolus thrombosis and pseudoalveolus disappearance rate ,and has higher clinical value .
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