TEVAR术治疗慢性Stanford B型主动脉夹层动脉瘤一例报告

TEVAR for Chronic Stanford Type B Aortic Dissecting Aneurysm: A Case Report

摘要: 2021年6月，一例以胸痛、头晕、手臂麻木为主要临床表现的62岁男性患者经心脏彩超、CTA检查后发现Stanford B主动脉夹层，入院予以控制血压、降心率等治疗，于入院第4 d行胸主动脉腔内修复术(Thoracic Endovascular Aortic Repair, TEVAR)，术后第二天患者胸痛、头晕等症状缓解，予以术后72 h后出院，出院5 d后患者无明显诱因出现胸背部疼痛，呈进行性加重，并出现咳嗽，饮水呛咳等症状，于术后28 d再次入院，行“胸主动脉造影术 + 胸主动脉假腔弹簧圈 + 人纤维蛋白粘合剂栓塞术”，术后予以控制血压、激素冲击治疗后胸痛症状明显缓解，声音嘶哑、饮水呛咳症状也得到较好改善。于术后10 d出院。

Abstract: In June 2021, a 62-year-old male patient with chest pain, dizziness and arm numbness as the main clinical manifestations was found to have Stanford B aortic dissection after cardiac color ultrasound and CTA examination. He was admitted to hospital and received treatment such as blood pressure control and heart rate reduction. Thoracic endovascular aortic repair (TEVAR) was performed on the 4th day of admission. Postoperative patients symptoms such as chest pain, dizziness ease the next day, after 72 h after hospital discharge, discharge from the 5 d after, the patient has no obvious incentives in the back of the chest pain, progression, and coughing, choking cough symptoms such as drinking water, to 28 d readmission, postoperative line “thoracic aortic angiography and thoracic aorta false lumen spring coil and fibrin glue embolization procedures”. After blood pressure control and hormone shock therapy, the symptoms of chest pain were significantly relieved, hoarseness and coughing from drinking water were also improved. The patient was discharged 10 days after surgery.