腔内修复术救治胸主动脉创伤的临床研究

摘要

Objective To explore the best timing and efficacy of endovascular repair ( EVR) for traumatic thoracic injuries (TAI). Methods A total of 19 cases with TAI were divided into emergency EVR group and delayed EVR group; 12 patients in the emergency EVR group underwent EVR within 24 hours after injuries while the other 7 patients in the delayed EVR group received conservative treatment for 2 weeks first and then underwent EVR treatment. All patients were followed up for CT and/or CTA. Results The emergency EVR group had 11 cases cured and 1 case dead. The delayed EVR group had 3 cases cured and 4 cases dead. The cure rate in the emergency EVR group was significantly higher than that in the delay EVR group (91.7% vs 42. 9% ). The 14 cured cases were followed up for 15. 5 months (range 1-47 months). During the follow-up,there was no death or obvious complication. Conclusion EVR is a fast, effective, and minimally invasive method for the treatment of TAI, and most patients with TAI should take EVR as the first choice in emergency.%目的 探讨腔内修复术(endovascular repair,EVR)救治胸主动脉创伤(thoracic aorticinjuries,TAI)的最佳时机及有效性.方法 19例TAI患者分为急诊EVR组和延迟EVR组,急诊EVR组12例为受伤后24 h内应用EVR救治；延迟EVR组7例为采取保守对症救治2周左右应用EVR治疗.同时对治愈出院患者随访其CT和/或CTA.结果 急诊EVR组治愈11例,死亡1例.延迟EVR组治愈3例,死亡4例.急诊EVR组的治愈率显著高于延迟EVR组(P＜0.05).14例救治成功的患者出院后,平均随访时间15.5个月(1～ 47个月),随访期间,无明显并发症、无死亡病例.结论 EVR是TAI的一种微创、快速、有效的救治方式,且多数TAI患者应在急诊下进行.