【摘要】：目的回顧性分析32例主動(dòng)脈夾層病變患者的臨床資料,探討升主動(dòng)脈至股(髂)動(dòng)脈旁路術(shù)在外科治療中的應(yīng)用,提高對(duì)此類患者外科治療的認(rèn)識(shí)。方法收集2004年10月至2013年12月,我院32例廣泛主動(dòng)脈夾層病變患者,男性28例(87.5%),女性4例(12.5%),年齡平均(42±9)歲。32名患者病變類型包括：28例A型夾層(12例急性夾層,16例慢性夾層),4例B型夾層伴升主動(dòng)脈瘤(均為慢性夾層)。隨訪途徑包括門診復(fù)查主動(dòng)脈CT和電話隨訪。結(jié)果在本組32例患者中,升主動(dòng)脈及主動(dòng)脈弓部手術(shù)操作包括：25例行升主動(dòng)脈-全弓+支架象鼻術(shù),5例行Bentall+全弓-支架象鼻術(shù),2例行Wheat+全弓十支架象鼻術(shù)。32例患者均行升主動(dòng)脈至右髂(或右股)旁路術(shù)。體外循環(huán)時(shí)間平均(206±66)min。停循環(huán)時(shí)間平均(26±10)min。住院時(shí)間平均(20±11)天。術(shù)后住院期間,2例患者死于多種嚴(yán)重的并發(fā)癥。術(shù)后24例出院患者返院復(fù)查CT(二期手術(shù)患者CT隨訪截止至二期術(shù)前),CT隨訪率80%,CT隨訪時(shí)間平均(9±7)個(gè)月。術(shù)后出院患者電話隨訪,2例失訪,電話隨訪率93%。隨訪期間無死亡病例。結(jié)論對(duì)于廣泛主動(dòng)脈夾層病變的患者,在升弓部手術(shù)后,升主動(dòng)脈至單側(cè)股(髂)動(dòng)脈人工血管旁路術(shù)可于術(shù)后早期緩解遠(yuǎn)端殘余主動(dòng)脈病變的進(jìn)展,同時(shí)能簡(jiǎn)化二期手術(shù)。
[Abstract]:Objective to analyze retrospectively the clinical data of 32 patients with aortic dissection, to explore the application of ascending aorta to femoral artery bypass in surgical treatment, and to improve the understanding of surgical treatment of these patients. Methods from October 2004 to December 2013, 32 patients with extensive aortic dissection, including 28 males (87.5%) and 4 females (12.5%), were collected. The mean age of 32 patients was (42 鹵9) years old. There were 28 patients with type A dissection (12 with acute dissection and 16 with chronic dissection) and 4 patients with type B dissection with ascending aortic aneurysm (all chronic dissection). The follow-up included outpatient review of aortic CT and telephone follow-up. Results among the 32 patients, the ascending aorta and aortic arch were operated on: 25 cases underwent ascending aorta total arch stenting rhinoplasty, 5 cases Bentall total arch stents rhinoplasty. 32 patients underwent ascending aorta to right iliac (or right femoral) bypass. Mean CPB time (206 鹵66) min. Circulatory arrest time averaged (26 鹵10) min. The average hospital stay was (20 鹵11) days. During hospitalization, 2 patients died of multiple severe complications. 24 patients who were discharged from hospital returned to hospital to check up CT (CT follow-up of secondary operation ended to the follow-up rate of), CT before secondary operation 80%). The average follow-up time was (9 鹵7) months. Telephone follow-up was performed in 2 patients, and the telephone follow-up rate was 933%. There were no deaths during follow-up. Conclusion for the patients with extensive aortic dissection, the ascending aorta to unilateral femoral (iliac) artery bypass surgery can relieve the progression of distal residual aortic lesions early after the operation, and can simplify the secondary operation at the same time.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R654.2

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相關(guān)期刊論文 前1條

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