关键词: 杂交手术, 支架象鼻术, 主动脉夹层, 并发症, 危险因素

Abstract: Objective：To investigate the difference of shortterm and midterm efficacy and risk factors of complications between hybrid operation and Bracket Elephant trunk technique in the treatment of complex type B aortic dissection.Methods：A retrospective analysis was made on 72 patients with complex type B aortic dissection treated in our hospital from January 2011 to January 2018.47 patients underwent hybrid operation and 25 patients underwent Bracket Elephant trunk technique.The differences of perioperative clinical indexes,shortterm curative effect,mediumterm curative effect and risk factors of complications between the two groups were compared.Result：The operation time,intraoperative bleeding volume,contrast medium usage and hospitalization time in the hybridization group were significantly lower than those in the Bracket Elephant trunk technique group;the aortic pseudocavities of the two groups decreased significantly after operation and one month after operation(P<0.05);Complication rate(17.02%) in the hybridization group was significantly lower than that in the Bracket Elephant trunk technique group(56.00%);Complication group and noncomplication group had significant differences in refractory hypertension,smoking history and aortic maximum diameter before operation(P< 0.05).Refractory hypertension,refractory hypertension,and aortic maximum diameter before operation(P<0.05).Smoking history and preoperative aortic maximum diameter can be used as independent risk factors for postoperative complications.Conclusion：Hybridization for complex type B aortic dissection has the same shortterm effect as Bracket Elephant trunk technique,and the longterm effect is better than the latter.At the same time,smoking history,preoperative aortic diameter and refractory hypertension history are highrisk factors for postoperative complications.

Key words: hybrid surgery, bracket elephant trunk technique, aortic dissection, complications, risk factors