B型主动脉夹层的围手术期管理进展

Advances in Perioperative Management of Type B Aortic Dissection

摘要

B型主动脉夹层(TBAD)是心血管急症领域最具挑战性的疾病之一。随着影像诊断技术的革新和胸主动脉腔内修复术(TEVAR)的普及,其诊断率和治愈率明显升高,死亡率明显下降。本文系统回顾TBAD的临床表现、诊疗策略,以及TEVAR在促进主动脉重塑中的核心作用。通过整合国际主动脉夹层注册研究数据及近年的随机对照试验证据,重点探讨手术时机、手术策略及相关并发症的防治。

Abstract

Type B aortic dissection (TBAD) remains one of the most challenging conditions in the realm of cardiovascular emergencies. Driven by innovations in imaging diagnostics and the widespread adoption of thoracic endovascular aortic repair (TEVAR), diagnostic rates and treatment success rates have significantly improved, while mortality has markedly declined. This article provides a systematic review of the clinical manifestations, diagnostic and management strategies for TBAD, with a focus on the pivotal role of TEVAR in promoting aortic remodeling. By integrating data from the international registry of acute aortic dissection and recent randomized controlled trial evidence, it critically examines the optimal timing of intervention, surgical strategies, and the prevention and management of associated complications.

关键词

B型主动脉夹层 / 胸主动脉腔内修复术 / 治疗策略 / 并发症

Key words

type B aortic dissection (TBAD) / thoracic endovascular aortic repair (TEVAR) / treatment strategies / complications

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基金资助

中央引导地方科技发展专项(2022BGE237)

湖北省卫生健康科技项目(WJ2025M048)