老年StanfordB型主动脉夹层的手术治疗  

Surgical treatment of Stanford type B aortic dissection in elderly patients

作　　者：祁海杰[1] 夏军[1] 王志维[1] 江洪[2] 戴飞锋[1] 

机构地区：[1]武汉大学人民医院心血管外科,430060 [2]武汉大学人民医院心血管内科,430060

出　　处：《临床外科杂志》2010年第5期302-304,共3页Journal of Clinical Surgery

摘　　要：目的探讨老年StanfordB型主动脉夹层患者的手术治疗方法。方法老年StanfordB型主动脉夹层患者47例分为两组，开放组采用深低温停循环下带支架人工血管置入术31例，介入组经股动脉行腔内覆膜支架人工血管植入术16例。结果开放组，2例死于多器官功能衰竭，1例死于急性心梗；2例术后出现脑梗塞，其中1例死亡；一过性精神障碍11例，声音嘶哑3例。介入组，术后出现左上肢缺血3例，脑梗塞2例，其中1例术后出现大面积脑梗塞，8d后死亡。结论对老年胸降主动脉夹层者须根据患者的不同情况，采用适合的治疗方法，以提高治疗效果。Objective To examine the surgical treatment of Stanford type B aortic dissection in elderly patients. Methods The clinical data of 47 cases of senile Stanford type B aortic dissection subjected to surgical treatment between Jan. 2005 to Nov. 2009 were retrospectively analyzed. The surgical treatments included placement of artificial vascular stents under profound hypothermia extracorporeal circulation （open group, n = 31 ）, and endovascular stent - graft placement through the femoral artery （interven- tional group, n = 16）. Results In the open group,2 patients died of muhiple organ failure syndrome and 1 of cardiac infarction after operation ;2 patients developed cerebral infarction, and one of them died ; 11 patients had transient neurologic syndromes and 3 patients developed hoarse voice. In the interventional group,3 patients developed left arm ischemia,2 patients showed cerebral infarction and one of them died of large cerebral infarction 8 d after the operation. Conclusion Different operation methods should be selected according to the different condition of senile Stanford type B aortic dissection so as to enhance the curative effect.

关 键 词：老年 主动脉夹层 支架血管 手术治疗 

分 类 号：R654.3[医药卫生—外科学]