中文摘要：

目的 总结Stanford B型主动脉夹层治疗的效果及临床经验.方法 回顾性分析2008年4月至2013年1月武汉大学人民医院213例Stanford B型主动脉夹层患者的临床资料,其中男172例,女41例,年龄23～83岁,平均（54±9）岁.根据病情选择保守治疗63例,手术治疗47例,腔内修复103例,对3组患者的临床资料及治疗效果进行统计学分析.结果 保守治疗组患者平均年龄大于手术治疗组.手术治疗组术前等待时间长于另外2组.手术治疗组同期行升主动脉、主动脉弓置换术3例,左锁骨下动脉开窗术19例;腔内修复组同期行颈部血管旁路移植术31例.保守治疗组院内死亡率为11.1％,手术治疗组为4.3％,腔内修复组为3.9％,3组之间差异无统计学意义.腔内组围术期并发症发生率较手术组低（P＜0.05）.随访186例患者,随访时间平均为（26±17）个月,随访期间3组的死亡率及并发症发生率差异无统计学意义.结论 对B型夹层患者应根据病情进行个体化治疗,可降低死亡率、并发症率,中期效果满意.

英文摘要：

Objective To summarize the mid-term result and clinical experience of individual treatment for Stanford type B aortic dissection.Method 213 patients （172 male,41 female） with Stanford type B aortic dissection were admitted between Apr 2008 and Jan 2013.Age ranged from 23 to 83 averaging 54 ± 9.63 patients were treated conservatively and 47 patients underwent open surgery,103 patients by endovascular repair.Result Patients in conservative group were older than those in open surgery group.Preoperative waiting time was the longest in open surgery group.Concomitant procedures adopted in open surgery group included replacement of ascending aorta and aortic arch in 3 patients and fenestration of stented elephant trunk in 19 patients; 31 patients received bypass graft of cervical vessels during endovascular repair.Mortality was 11.1％,4.3％,3.9％ in conservative group,open surgery group and endovascular group,respectively.Compared with open surgery,endovascular repair had a lower incidence of perioperative complications （P ＜ 0.05）.186 patients were followed-up with a mean follow-up duration of （26± 17） months.There were no difference in mortality and complications between the three groups.Conclusions In Stanford B aortic dissection,individualized therapy based on patient＇s condition achieves a favorable mid-term result with low mortality and complication rate.