支架象鼻技术治疗胸主动脉夹层动脉瘤早中期效果Meta分析

山东大学学报(医学版) ›› 2010, Vol. 48 ›› Issue (6): 92-.

支架象鼻技术治疗胸主动脉夹层动脉瘤早中期效果Meta分析

李滨1，孙立忠2，赵鑫1，郑军2，常谦1，于存涛1，朱俊明2，刘永民2

1. 北京协和医学院中国医学科学院阜外心血管病医院血管外科中心, 北京 100037；
2．北京首都医科大学安贞医院心外科，北京 100029

收稿日期:2009-10-23 出版日期:2010-06-16 发布日期:2010-06-16
通讯作者: 孙立忠（1960- ），男，博士，主任医师，研究方向为主动脉夹层治疗策略。 E-mail:slzh-2005@yahoo.com
作者简介:李滨（1977- ），男，博士研究生，主治医师，研究方向为Stanford B型夹层治疗策略。
基金资助:
北京市科技计划资助项目(Z07050700690715)。

The early and mid-term result of the stened elephant trunk technique for the treatment of extensive thoracic aortic aneurysms:A Meta-Analysis

LI Bin1, SUN Lizhong2, ZHAO Xin1, ZHENG Jun2,　CHANG Qian1,YU Cuntao1,　ZHU Junming2,　LIU Yongmin2

1. Department of Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;
2. Department of Cardiovascular Surgery, Cardiovascular Institute and Anzhen Hospital,
Capital University of Medical Sciences, Beijing 100029, China

Received:2009-10-23 Online:2010-06-16 Published:2010-06-16

摘要/Abstract

摘要：

目的通过Meta分析方法，对应用支架象鼻手术的早中期效果进行评估。方法通过检索Embase及 Pubmed文献数据库，检索筛选获取2009年8月前发表的关于应用支架象鼻手术的12篇临床研究（538例患者）。结果支架象鼻手术后住院期间死亡率为（5.0±0.9）%；术后肾功能衰竭发生率(3.5±0.8)%；截瘫或者下肢轻瘫的发生率为（3.5±0.8）%；脑卒中的发生率为（2.9±0.7）%。总体平均随访（36.0±20.3）个月，中期生存率分别为1年（94.30±0.16）%；2年（93.60±0.11）%；5年（91.40±0.14）%。结论支架象鼻手术早中期能够降低手术死亡率及并发症的发生率，中期随访证实能够促使假腔内血栓的形成、封闭假腔。

关键词: 支架象鼻术;主动脉瘤;主动脉夹层

Abstract:

Objective To summarize studies on stented elephant trunk procedure (SET) for extensive thoracic aortic aneurysms. Methods In this systematic review and Metaanalysis of all English language literatures of SET through searches of the electronic databases EMBASE and Medline before August 2009, 12 studies, involving a total of 538 patients, were included. Results Twenty-seven of 542 patients with available data died during the in-hospital period, yielding an overall in-hospital mortality rate of （5.0±0.7）%; the incidence of postoperatiove renal failure was (3.5±0.8)%; stroke occurred in （2.9±0.7）% of the patients; paraplegia or paraparesis was reported with an incidence of (3.5±0.8)%. Over a mean follow-up period of (36.0±20.3) months, Kaplan-Meier analysis yielded overall survival rates of (94.30±0.10)% at 1 year, (93.60±0.11)% at 2 years, and (91.40±0.14)% at 5 years, respectively. Conclusions The SET technique represents an effective surgical option for the treatment of extensive aortic aneurysm with low early morbidity and mortality.Moreover, the efficacy in closing the rsidual false lumen of the desecending aorea is proved in the middle-term.

Key words: Stented elephant trunk; Extended thoracic aneurysms; Aortic dissection

中图分类号:

R654.1

李滨1，孙立忠2，赵鑫1，郑军2，常谦1，于存涛1，朱俊明2，刘永民2. 支架象鼻技术治疗胸主动脉夹层动脉瘤早中期效果Meta分析[J]. 山东大学学报(医学版), 2010, 48(6): 92-.

LI Bin1, SUN Lizhong2, ZHAO Xin1, ZHENG Jun2,　CHANG Qian1,YU Cuntao1,　ZHU Junming2,　LIU Yongmin2. The early and mid-term result of the stened elephant trunk technique for the treatment of extensive thoracic aortic aneurysms:A Meta-Analysis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(6): 92-.

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