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生活质量:改良三分支支架移植物植入术与冷冻象鼻技术。

Quality of life: modified triple-branched stent graft implantation versus frozen elephant trunk technique.

机构信息

Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.

Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China.

出版信息

J Cardiothorac Surg. 2021 Oct 13;16(1):297. doi: 10.1186/s13019-021-01683-9.

Abstract

OBJECTIVE

To compare the effects of modified triple-branched stent implantation and frozen elephant trunk technique on the quality of life (QoL) of acute Stanford Type A aortic dissection (AAAD) patients at different follow-up times.

METHODS

Data from 175 AAAD survivors was collected which were divided into two groups according to different surgical techniques: (group A): modified triple-branched stent graft implantation; (group B): frozen elephant trunk. The SF-36 were used to assess the QoL at discharge (AD), the third postoperative month (POM3), and the twelfth postoperative month (POM12).

RESULTS

(1) The total scores at each time of both groups showed lower than the normal level; Group A scored higher than group B at some time points in terms of some items (role physical, role emotion and mental health; all P = 0.000), and some items at POM3 or POM12 scored higher than at discharge (role physical, social function; both P = 0.000). (2) There were less patients with heavy self-perceived burden in group A than group B at discharge (P = 0.032) and patients with heavy self-perceived burden decreased over time. (3) Young postoperative AAD patients (P = 0.002) in group B (P = 0.005) with heavy self-perceived burden (P = 0.000), acute renal failure (P = 0.008), long LOS (P = 0.026) and blood loss (> 1000 mL/24 h) (P = 0.039) seemed to get a worse QoL.

CONCLUSION

The impact on QoL of the modified triple-branched stent graft implantation technique seemed to be better than those of frozen elephant trunk surgery in role physical, role emotion and mental health.

摘要

目的

比较改良三分支支架植入术与孙氏手术对不同随访时间急性 Stanford A 型主动脉夹层(AAAD)患者生活质量(QoL)的影响。

方法

收集 175 例 AAAD 幸存者的数据,根据不同的手术技术分为两组:(A 组)改良三分支支架植入术;(B 组)孙氏手术。采用 SF-36 量表在出院时(AD)、术后第 3 个月(POM3)和术后第 12 个月(POM12)评估 QoL。

结果

(1)两组各时间点总分均低于正常水平;在某些项目(生理职能、情感职能和心理健康;均 P=0.000)上,A 组在某些时间点的得分高于 B 组,且在 POM3 或 POM12 时某些项目的得分高于出院时(生理职能、社会功能;均 P=0.000)。(2)出院时 A 组自我感觉负担较重的患者少于 B 组(P=0.032),且随着时间的推移,自我感觉负担较重的患者减少。(3)B 组年轻术后 AAAD 患者(P=0.002)、自我感觉负担较重的患者(P=0.000)、急性肾功能衰竭(P=0.008)、较长 LOS(P=0.026)和出血量(>1000ml/24h)(P=0.039)的患者 QoL 较差。

结论

改良三分支支架植入术对 QoL 的影响在生理职能、情感职能和心理健康方面似乎优于孙氏手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ae/8513261/29fea46cb3e0/13019_2021_1683_Fig1_HTML.jpg

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