Ueda T, Kawada S
Department of Cardiovascular Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1996 Oct;97(10):916-20.
We retrospectively analyzed the operative results and the long-term prognosis of aortic dissections. Between 1966 and 1996, we operated upon 137 patients with aortic dissection. According to the date of the first operation, they were classified into early (1966, 1985), middle (1985, 1992), and late (1992, 1996) cases. The hospital mortality rates of Stanford type. A patients were 40% (12/30) for early cases, 21 (6/28) for middle cases, and 13% (3/24) for late cases. Those of type-B patients were 10% (3/30) for early cases, 21% (3/11) for middle cases and 6% (1/16) for late cases. Actuarial survival rates for the all operative survivors of type-A patients (n = 60) were 77% at five year and 63% at 10 year. Those of type-B patients were 63% at five year and 20% at ten year. The difference of the two survival curves was significant (p < 0.01). In conclusion, the operative mortality rates for both type-A and type-B aortic dissection have reduced. But the more extended and rationale operation is recommended especially for type-B dissection in order to improve long-term prognosis.
我们回顾性分析了主动脉夹层的手术结果及长期预后。1966年至1996年间，我们对137例主动脉夹层患者进行了手术。根据首次手术日期，将他们分为早期（1966年至1985年）、中期（1985年至1992年）和晚期（1992年至1996年）病例。斯坦福A型患者的早期病例医院死亡率为40%（12/30），中期病例为21%（6/28），晚期病例为13%（3/24）。B型患者的早期病例为10%（3/30），中期病例为21%（3/11），晚期病例为6%（1/16）。A型患者所有手术幸存者（n = 60）的精算生存率5年时为77%，10年时为63%。B型患者5年时为63%，10年时为20%。两条生存曲线的差异具有显著性（p < 0.01）。总之，A型和B型主动脉夹层的手术死亡率均有所降低。但为改善长期预后，尤其对于B型夹层，建议进行更广泛且合理的手术。
