临床误诊误治2026，Vol.39Issue(11)：46-51,6.DOI:10.3969/j.issn.1002-3429.2026.11.008
海拔高度对覆膜支架腔内隔绝术治疗B型主动脉夹层患者影像学变化及术后并发症的影响
Effect of altitude on imaging changes and postoperative complications in patients with type B aortic dissection undergoing thoracic endovascular aortic repair
摘要
Abstract
Objective To investigate the effect of altitude on the imaging changes and postoperative complications of patients with type B aortic dissection(TBAD)undergoing thoracic endovascular aortic repair(TEVAR).Methods A total of 200 patients diagnosed with TBAD and treated with TEVAR at Qinghai Cardio-Cerebrovascular Hospital from January 2010 to December 2019 were selected.They were divided into the plateau group(n=100)and the plain area group(n=100)based on the altitude of their residence.The plateau group and the plain area group consisted of patients who had continuously resided in areas with an altitude greater than 3,000 meters and those with an altitude of 3,000 meters or less for at least 6 months.CT angiography was used to evaluate the imaging indicators at 6 months,1 year,and 3 years after the operation.The occurrence of complications within 3 years after the operation was compared between the two groups,and multivariate logistic regression analysis was applied to identify the risk factors influencing the occurrence of complications.Results The true lumen volume expansion rate and false lumen volume reduction rate of the plateau group were lower than those of the plain group at 6 months,1 year and 3 years after surgery,while the thrombosis rate of the false lumen was higher in the plateau group than in the plain group at 6 months and 1 year after surgery(P<0.05).The rates of endoleak,retrograde type A aortic dissection and cerebral infarction in the plateau group within 3 years after surgery were 12.00%(12/100),10.00%(10/100)and 15.00%(15/100),respectively,which were higher than those of the plain group[4.00%(4/100),3.00%(3/100)and 6.00%(6/100),P<0.05].Altitude and age were independent risk factors for the incidence of postoperative complications in patients with TBAD(P<0.05).Conclusion The altitude level significantly affects the imaging changes and the risk of complications in patients with TBAD after TEVAR.More attention should be paid to the postoperative management of patients in high-altitude areas to reduce the incidence of complications and improve prognosis.关键词
B型主动脉夹层/覆膜支架腔内隔绝术/海拔高度/影像学评估/术后并发症/危险因素Key words
type B aortic dissection/thoracic endovascular aortic repair/altitude/imaging evaluation/postoperative complications/risk factor引用本文复制引用
赵名贤,李国杰..海拔高度对覆膜支架腔内隔绝术治疗B型主动脉夹层患者影像学变化及术后并发症的影响[J].临床误诊误治,2026,39(11):46-51,6.基金项目
2022年青海省卫生健康系统指导性计划课题(2022-wjzdx-47) （2022-wjzdx-47）
